A Redesigned Order Entry System for Reducing Low-Value Preprocedural Cardiology Consultations: Quality-Improvement...

Preprocedural cardiac evaluations often lead to outpatient cardiology visits. Many of these consultations are low-risk and unnecessary. Reducing low-value consultations can ease time and travel burdens for patients. Prior research has shown that geographic spread affects patient access. No prior work had resolved how to guide clinicians toward appropriate referrals. This gap motivated a study of an electronic order entry system. The study aimed to assess whether an algorithm could reduce unnecessary consultations. The study also examined whether electronic consultations could improve access. The goal was to evaluate the impact of a redesigned system on consultation patterns.

The study aimed to assess the impact of a redesigned electronic order entry system on preprocedural cardiology consultations. The system was designed to guide clinicians toward appropriate referrals. The goal was to reduce low-value consultations and improve patient access. The study compared consultation patterns before and after implementation. The focus was on whether the algorithm changed consultation types. The study also examined whether electronic consultations increased. The motivation was to reduce unnecessary travel and time for patients. The researchers sought to evaluate the algorithm’s effect on clinic workflow.

The study used a retrospective review of cardiology consultations. Data were collected from in-person and electronic consultations. The period before and after algorithm implementation was compared. A custom electronic database stored the data. The researchers reviewed 603 consultations before implementation. Of these, 89 were preprocedural evaluations. After implementation, 360 consultations were reviewed. The proportion of preprocedural consultations was analyzed. The study also tracked the number of electronic consultations.

Before implementation, 14.7% of consultations were preprocedural evaluations. Of these, 43.8% were electronic consultations. After implementation, the proportion of preprocedural consultations remained unchanged. The number of electronic consultations increased by 13.6%. The postintervention period saw 13.0% preprocedural consultations. No adverse events were reported by ordering clinicians. No concerns were raised about the process change. The increase in electronic consultations may have improved clinic access.

The algorithm did not reduce the number of preprocedural cardiology consultations. However, the number of electronic consultations increased significantly. This may have improved access and reduced travel burdens for patients. The study found no adverse effects from the system change. No feedback from clinicians indicated dissatisfaction. The findings suggest electronic consultations could enhance clinic efficiency. The algorithm’s design aimed to guide appropriate referrals. The results highlight the potential of electronic tools in healthcare.