Anat Ben-Shlomo1, Joseph Guzman2, James Mirocha3. 1. Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Davis Building, Room 3021, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA. anat.benshlomo@cshs.org. 2. Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Davis Building, Room 3021, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA. 3. Biostatistics Core, Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Abstract
PURPOSE: To improve performance of the cosyntropin stimulation test (CST) used for diagnosis of adrenal-cortisol insufficiency by implementing an electronic medical record (EMR) system protocol. METHODS: We implemented a SmartForm protocol of the validated CST in our EMR system (CS-Link™, EPIC) system and compared medical staff test performance before and after protocol implementation. RESULTS: Correct performance of the CST improved significantly after EMR implementation. The number of correctly performed CSTs increased from 16.1 % before to 53.5 % after implementation (p < 0.0001) while those performed incorrectly and were uninterpretable decreased from 36.2 to 7.1 % (p < 0.0001). This performance improvement result in a calculated cost savings of $50,414 for every 100 tests performed. CONCLUSIONS: The EMR system is useful for guiding medical staff to accurately perform the CST, reduce the number of wasted tests, and maximize staff time and resources.
PURPOSE: To improve performance of the cosyntropin stimulation test (CST) used for diagnosis of adrenal-cortisol insufficiency by implementing an electronic medical record (EMR) system protocol. METHODS: We implemented a SmartForm protocol of the validated CST in our EMR system (CS-Link™, EPIC) system and compared medical staff test performance before and after protocol implementation. RESULTS: Correct performance of the CST improved significantly after EMR implementation. The number of correctly performed CSTs increased from 16.1 % before to 53.5 % after implementation (p < 0.0001) while those performed incorrectly and were uninterpretable decreased from 36.2 to 7.1 % (p < 0.0001). This performance improvement result in a calculated cost savings of $50,414 for every 100 tests performed. CONCLUSIONS: The EMR system is useful for guiding medical staff to accurately perform the CST, reduce the number of wasted tests, and maximize staff time and resources.
Authors: Stephanie M Gwin; Annika K Khine; Anat Ben-Shlomo; James Mirocha; Ning-Ai Liu; Renee C Sheinin; Shlomo Melmed Journal: Am J Med Date: 2014-03-13 Impact factor: 4.965
Authors: Diane Lipiner-Friedman; Charles L Sprung; Pierre François Laterre; Yoram Weiss; Sergey V Goodman; Michael Vogeser; Josef Briegel; Didier Keh; Mervyn Singer; Rui Moreno; Eric Bellissant; Djillali Annane Journal: Crit Care Med Date: 2007-04 Impact factor: 7.598