A minimalist electronic health record-based intervention to reduce standing lab utilisation. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive. OBJECTIVE: To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation. SETTING: One year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU). INTERVENTION: Providers were required to specify the number of times each test should occur instead of being able to order them indefinitely. MEASUREMENTS: For eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured. RESULTS: Utilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU. CONCLUSIONS: Requiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.

publication date

  • February 12, 2020

Research

keywords

  • Diagnostic Tests, Routine
  • Electronic Health Records
  • Practice Patterns, Physicians'
  • Unnecessary Procedures
  • Utilization Review

Identity

Scopus Document Identifier

  • 85100128544

Digital Object Identifier (DOI)

  • 10.1136/postgradmedj-2019-136992

PubMed ID

  • 32051280

Additional Document Info

volume

  • 97

issue

  • 1144