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Information sharing can reduce laboratory use by emergency physicians
1Section of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Abstract:
This study analyzed the effect information sharing through physician profiling would have on emergency physician behavior. It is a before-and-after audit of laboratory use in a community hospital. A 9-month control period was followed by a 15-month period in which the physicians' laboratory use was presented and discussed at monthly meetings. The laboratory use decreased 17.8%, from a mean of 2.36 studies per patient during the control period to 1.94 during the final quarter of the study. The actual laboratory costs per month decreased 17.7%, from a mean of $32,415 per month to $26,687 per month. There was only one possible adverse outcome out of 34,320 patients seen. There were no adverse changes in other quality improvement indicators. Information sharing can result in a decrease in the number and cost of laboratories studies ordered by emergency physicians without an adverse change in routine quality improvement indicators.
Insights
Sharing physician laboratory use data reduced testing by 17.8% and costs by 17.7% in emergency departments. This information sharing strategy improved physician behavior without negatively impacting patient care quality indicators.
Area of Science:
- Health Services Research
- Medical Informatics
- Clinical Practice Improvement
Background:
- Physician behavior significantly influences healthcare costs and resource utilization.
- Effective information sharing strategies are crucial for optimizing clinical practice.
Purpose of the Study:
- To evaluate the impact of physician profiling and information sharing on laboratory test ordering in emergency medicine.
- To assess changes in laboratory utilization, associated costs, and patient outcomes.
Main Methods:
- A before-and-after audit design was employed in a community hospital setting.
- A 9-month control period was followed by a 15-month intervention period.
- Physicians' laboratory use data were presented and discussed in monthly meetings.
Main Results:
- Laboratory test utilization decreased by 17.8% (from 2.36 to 1.94 studies per patient).
- Monthly laboratory costs decreased by 17.7% (from $32,415 to $26,687).
- Only one potential adverse outcome was noted among 34,320 patients, with no negative changes in quality indicators.
Conclusions:
- Information sharing via physician profiling can effectively reduce laboratory test ordering by emergency physicians.
- This approach leads to significant cost savings without compromising routine quality of care.
- Physician feedback and discussion are valuable tools for behavior modification in clinical practice.