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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. 18000 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.
View details for DOI 10.1136/postgradmedj-2019-136992
View details for PubMedID 32051280