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

Abstract

Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive. To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation. 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). Providers were required to specify the number of times each test should occur instead of being able to order them indefinitely. For eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured. 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. Requiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.