Literature DB >> 27124918

Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital.

Raymond L Konger1, Paul Ndekwe2, Genea Jones3, Ronald P Schmidt4, Marty Trey5, Eric J Baty3, Denise Wilhite3, Imtiaz A Munshi6, Bradley M Sutter7, Maddamsetti Rao7, Chowdry M Bashir8.   

Abstract

OBJECTIVES: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing.
METHODS: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.
RESULTS: Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged.
CONCLUSIONS: Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care. Published by Oxford University Press on behalf of the American Society for Clinical Pathology, 2016. This work is written by US Government employees and is in the public domain in the US.

Entities:  

Keywords:  Clinical laboratory; Cost containment; Frequency filter; Test reduction; Utilization management

Mesh:

Year:  2016        PMID: 27124918     DOI: 10.1093/ajcp/aqv092

Source DB:  PubMed          Journal:  Am J Clin Pathol        ISSN: 0002-9173            Impact factor:   2.493


  12 in total

Review 1.  Strategies for utilisation management of hospital services: a systematic review of interventions.

Authors:  Leila Doshmangir; Roghayeh Khabiri; Hossein Jabbari; Morteza Arab-Zozani; Edris Kakemam; Vladimir Sergeevich Gordeev
Journal:  Global Health       Date:  2022-05-23       Impact factor: 10.401

2.  Predicting Low Information Laboratory Diagnostic Tests.

Authors:  Shivaal K Roy; Jason Hom; Lester Mackey; Neil Shah; Jonathan H Chen
Journal:  AMIA Jt Summits Transl Sci Proc       Date:  2018-05-18

Review 3.  Reducing Test Utilization in Hospital Settings: A Narrative Review.

Authors:  Renuka S Bindraban; Maarten J Ten Berg; Christiana A Naaktgeboren; Mark H H Kramer; Wouter W Van Solinge; Prabath W B Nanayakkara
Journal:  Ann Lab Med       Date:  2018-09       Impact factor: 3.464

4.  The role of a best practice alert in the electronic medical record in reducing repetitive lab tests.

Authors:  Harini Bejjanki; Lazarus K Mramba; Stacy G Beal; Nila Radhakrishnan; Rohit Bishnoi; Chintan Shah; Nikhil Agrawal; Neil Harris; Robert Leverence; Kenneth Rand
Journal:  Clinicoecon Outcomes Res       Date:  2018-10-08

5.  Engaging residents to choose wisely: Resident Doctors of Canada resource stewardship recommendations.

Authors:  Justin Hall; Reza Mirza; James Quinlan; Evan Chong; Karen Born; Brian Wong; Christopher Hillis
Journal:  Can Med Educ J       Date:  2019-03-13

6.  An Optimal Policy for Patient Laboratory Tests in Intensive Care Units.

Authors:  Li-Fang Cheng; Niranjani Prasad; Barbara E Engelhardt
Journal:  Pac Symp Biocomput       Date:  2019

7.  Expert Recommendations on Frequency of Utilization of Common Laboratory Tests in Medical Inpatients: a Canadian Consensus Study.

Authors:  Anshula Ambasta; Stefana Pancic; Brian M Wong; Todd Lee; Deirdre McCaughey; Irene W Y Ma
Journal:  J Gen Intern Med       Date:  2019-08-05       Impact factor: 5.128

Review 8.  Economic impact of clinical decision support interventions based on electronic health records.

Authors:  Daniel Lewkowicz; Attila Wohlbrandt; Erwin Boettinger
Journal:  BMC Health Serv Res       Date:  2020-09-15       Impact factor: 2.655

9.  Effectiveness of minimum retesting intervals in managing repetitive laboratory testing: experience from a Croatian university hospital.

Authors:  Ivana Lapić; Dunja Rogić; Mirjana Fuček; Ružica Galović
Journal:  Biochem Med (Zagreb)       Date:  2019-10-15       Impact factor: 2.313

10.  Prevalence and Predictability of Low-Yield Inpatient Laboratory Diagnostic Tests.

Authors:  Song Xu; Jason Hom; Santhosh Balasubramanian; Lee F Schroeder; Nader Najafi; Shivaal Roy; Jonathan H Chen
Journal:  JAMA Netw Open       Date:  2019-09-04
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