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Related Experiment Videos

Prompting for cost-effective test ordering: a randomized controlled trial

G R Hollingworth1, R M Bernstein, G S Viner

  • 1Clinical Epidemiology Unit, Elisabeth Bruyere Health Centre, University of Ottawa.

Proceedings. Symposium on Computer Applications in Medical Care
|January 1, 1995
PubMed
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A computerized prompting system significantly reduced medical test orders by 38% and costs by 12%. This clinical decision support tool promotes appropriate test ordering and saves healthcare dollars.

Area of Science:

  • Medical Informatics
  • Health Services Research
  • Clinical Decision Support

Background:

  • Inappropriate test ordering contributes to healthcare costs.
  • Clinical decision support systems can improve diagnostic accuracy and resource utilization.

Purpose of the Study:

  • To evaluate the efficacy of a computerized prompting system for medical test ordering.
  • To assess the impact of the system on test order volume and associated costs.

Main Methods:

  • Randomized controlled trial using clinical vignettes.
  • System utilizes test sensitivity, specificity, and predictive values.
  • Tested with first and second-year residents in an academic family medicine center.

Main Results:

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  • A 38% decrease in the number of tests ordered (p < .01).
  • A 12% reduction in the cost of tests ordered.
  • Significant cost savings and improved ordering practices observed.

Conclusions:

  • Computerized prompting systems can effectively reduce unnecessary test orders.
  • Implementation at the point of patient encounter enhances appropriateness.
  • Potential for substantial healthcare cost savings identified.