MU researcher finds way to reduce unnecessary lab tests, decrease patient costs by modifying software

November 04, 2013

COLUMBIA, Mo. - 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 lab tests can result in unnecessary testing and can cause physical discomfort and financial stress to patients," 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 clinicians."

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 medical professionals 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 software 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.
-end-


University of Missouri-Columbia

Related Physicians Articles from Brightsurf:

Needlestick, sharps injuries among resident physicians
Rates and characteristics of needle stick and other sharps injuries among resident physicians and other staff at a large health care center were examined in this study.

Prevalence of suicide-related behaviors among physicians
An analysis of published studies has found a relatively high prevalence of suicidal behaviors among physicians.

To support lactating emergency physicians, consider these strategies
A new paper highlights strategies that emergency departments can implement to support lactating emergency physicians.

Physicians call for an end to conversion therapy
Historically, conversion therapies have used electroshock therapy, chemical drugs, hormone administrations and even surgery.

Racial bias associated with burnout among resident physicians
Symptoms of physician burnout appear to be associated with greater bias toward black people in this study of nearly 3,400 second-year resident physicians in the United States who identified as nonblack.

Survey finds physicians struggle with their own self-care
Despite believing that self-care is a vitally important part of health and overall well-being, many physicians overlook their own self-care, according to a new survey released today, conducted by The Harris Poll on behalf of Samueli Integrative Health Programs.

Less burnout seen among US physicians, Stanford researcher says
The epidemic levels of physicians reporting burnout dropped modestly in 2017, according to a study by researchers at the Stanford University School of Medicine, the Mayo Clinic and the American Medical Association.

Payments to physicians may increase opioid prescribing
US doctors who receive direct payments from opioid manufacturers tend to prescribe more opioids than doctors who receive no such payments, according to new research published by Addiction.

Is marketing of opioids to physicians associated with overdose deaths?
This study examined the association between pharmaceutical company marketing of opioids to physicians and subsequent death from prescription opioid overdoses across US counties.

Nearly half of resident physicians report burnout
Resident physician burnout in the US is widespread, with the highest rates concentrated in certain specialties, according to research from Mayo Clinic, OHSU and collaborators.

Read More: Physicians News and Physicians Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.