A minimalist electronic health record-based intervention to reduce standing lab utilisation.

Overview

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.