Implementing minimal request intervals for laboratory tests: a utilization management study across eight hospitals in...

Area of Science:

• Laboratory Medicine
• Health Informatics
• Healthcare Management

Background:

• Effective utilization management in medical laboratories presents a significant challenge.
• Strategies like clinical guidelines, minimum requesting intervals (MRIs), and test request limits integrated into hospital information systems (HIS) have been proposed to address this.
• Optimizing laboratory test ordering is crucial for resource efficiency and cost reduction.

Purpose of the Study:

• To develop and implement MRI guidelines for high-demand laboratory tests.
• To evaluate the impact of integrating these guidelines into the HIS on test utilization and financial savings.
• To assess the effectiveness of HIS-based alerts in managing laboratory test requests.

Main Methods:

• An expert panel developed MRIs for 15 high-demand laboratory tests.
• Guidelines were implemented across eight public hospitals, with the HIS programmed to notify healthcare providers of deviations.
• Test utilization metrics and financial data were collected for one year pre- and post-intervention.

Main Results:

• A total of 414,475 unnecessary laboratory tests were averted in the first year post-intervention.
• The test-to-hospitalization-day ratio decreased by 12.26%.
• Significant reductions were observed in serum calcium (25.87%), serum albumin (22.17%), and alanine aminotransferase (21.03%) testing.

Conclusions:

• Integrating MRI guidelines into the HIS is an effective strategy for laboratory utilization management.
• This approach leads to substantial financial savings for patients and insurers.
• Benefits include minimized diagnostic ambiguity, improved patient management, and optimized laboratory resource allocation.