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Information sharing can reduce laboratory use by emergency physicians

E A Ramoska1

  • 1Section of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

The American Journal of Emergency Medicine
|February 6, 1998
PubMed
Summary

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.

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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.

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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.