Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center

Matthew D Krasowski; Deborah Chudzik; Anna Dolezal; Bryan Steussy; Michael P Gailey; Benjamin Koch; Sara B Kilborn; Benjamin W Darbro; Carolyn D Rysgaard; Julia A Klesney-Tait

doi:10.1186/s12911-015-0137-7

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Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center

Journal article

Open access

Peer reviewed

Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center

Matthew D Krasowski, Deborah Chudzik, Anna Dolezal, Bryan Steussy, Michael P Gailey, Benjamin Koch, Sara B Kilborn, Benjamin W Darbro, Carolyn D Rysgaard and Julia A Klesney-Tait

BMC medical informatics and decision making, Vol.15(1), pp.11-11

2015

DOI: 10.1186/s12911-015-0137-7

PMCID: PMC4344785

PMID: 25880934

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Abstract

This case study over time describes five years of experience with interventions to improve laboratory test utilization at an academic medical center. The high-frequency laboratory tests showing the biggest declines in order volume post intervention were serum albumin (36%) and erythrocyte sedimentation rate (17%). Introduction of restrictions for 170 high-cost send-out tests resulted in a 23% decline in order volume. Targeted interventions reduced mis-orders involving several “look-alike” tests: 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D; manganese, magnesium; beta-2-glycoprotein, beta-2-microglobulin. Lastly, targeted alerts reduced duplicate orders of germline genetic testing and orders of hepatitis B surface antigen within 2 weeks of hepatitis B vaccination.

Electronic Health Records

Medical Informatics

Correspondence

Serum albumin

Vitamin D

Blood cell count

Details

Title: Subtitle: Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center
Creators: Matthew D Krasowski - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Deborah Chudzik - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Anna Dolezal - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Bryan Steussy - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Michael P Gailey - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Benjamin Koch - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Sara B Kilborn - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Benjamin W Darbro - Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Carolyn D Rysgaard - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Julia A Klesney-Tait - Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
Resource Type: Journal article
Publication Details: BMC medical informatics and decision making, Vol.15(1), pp.11-11
DOI: 10.1186/s12911-015-0137-7
PMID: 25880934
PMCID: PMC4344785
NLM abbreviation: BMC Med Inform Decis Mak
ISSN: 1472-6947
eISSN: 1472-6947
Publisher: BioMed Central; London
Language: English
Date published: 2015
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Stead Family Department of Pediatrics; Pathology; Medical Genetics and Genomics; Internal Medicine
Record Identifier: 9984047667202771

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