Researchers find way to reduce unnecessary lab tests, decrease patient costs by modifying software

November 4, 2013, University of Missouri-Columbia

When patients undergo diagnostic lab tests as part of the inpatient admission process, they may wonder why or how physicians choose particular tests. Increasingly, medical professionals are using electronic medical systems that provide lists of lab tests from which medical professionals can choose. Now, a University of Missouri researcher and her colleagues have studied how to modify these lists to ensure health professionals order relevant tests and omit unnecessary lab tests, which could result in better care and reduced costs for patients.

"Ordering numerous can result in unnecessary testing and can cause physical discomfort and financial stress to ," said Victoria Shaffer, an assistant professor of health sciences in the MU School of Health Professions. "We found that by changing the way electronic order set lists were designed, we could significantly alter both the number and quality of lab tests ordered by ."

Shaffer and her research team studied how physicians selected lab tests using three order set list designs on the same electronic medical system. The first order set list design was an opt-in version in which no lab tests were pre-selected; this is the standard method of lab test ordering in electronic health records for most healthcare facilities. A second option was an opt-out version in which physicians had to de-select lab tests they believed were not clinically relevant. In the third design, only a few tests were pre-selected based on recommendations by pediatric experts. On average, clinicians ordered three more tests when using the opt-out version than the opt-in or recommended versions. However, providers ordered more tests recommended by the pediatric experts when using the recommended design than when using the opt-in design.

"Essentially we found that including default selections, either with the opt-out method or the recommended method, increased the quality of lab tests the clinicians ordered. That is, clinicians ordered more tests recommended by pediatric experts with these methods," Shaffer said. "However, there were costs associated with using these approaches. Use of the opt-out method costs about $71 more per patient. Using a set of recommended defaults keeps costs down but requires consensus about which tests to set as defaults."

Shaffer, who also is an assistant professor of psychological sciences in the MU College of Arts and Science, believes that to further improve medical software and create the best end product, information technology (IT) experts who design the software should collaborate with experts who study how people interact with technology and who would use the software.

"Problems with these software systems often occur because IT experts design the software with minimal input from the people who use it," Shaffer said. "IT experts and medical professionals should work together to design these systems to reach optimal performance, which results in the best care for patients. A wide variety of methods exist that could improve medical lab test ordering and would ensure that only the most appropriate, relevant lab tests for patients are ordered while saving money in the long run."

Shaffer partnered with Adam Probst from Baylor Scott & White Health and Raymond Chan from Children's Mercy Hospitals and Clinics in Kansas City, Mo. Their study was published in Health Psychology.

Explore further: Electronic test result access does not reduce test ordering

Related Stories

Electronic test result access does not reduce test ordering

March 6, 2012
(HealthDay) -- For office-based physicians, electronic access to patient imaging and laboratory test results does not decrease -- and may actually increase -- the number of diagnostic tests ordered, according to research ...

Patients discharged without test results

August 14, 2012
Close to half of the tests ordered by doctors on the day of a patient's discharge from hospital are not looked at again, UNSW research has found.

Digital diagnostic tools lead to patient dissatisfaction, says MU expert

January 24, 2013
Health care practitioners now can access patients' data using electronic medical records, which often include information systems that assess individuals' medical histories and clinical research to facilitate doctors' diagnoses. ...

Stories help patients make health decisions, researcher says

June 4, 2013
(Medical Xpress)—Stories often appear in health communication in order to encourage individuals to change behaviors, such as smoking or not wearing sunscreen. A University of Missouri researcher studied how stories influence ...

Asymptomatic often sent for lung cancer screening tests

March 13, 2012
(HealthDay) -- A majority of primary care physicians report ordering lung cancer screening tests for asymptomatic patients, according to research published in the March/April issue of the Annals of Family Medicine.

Researchers tackle physician challenge of correctly ordering laboratory tests

March 21, 2013
A new study involving researchers from the Boston University School of Medicine (BUSM) has identified barriers that clinicians face in correctly ordering appropriate laboratory tests and highlights some solutions that may ...

Recommended for you

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.