Medical testing is seldom an enjoyable experience, so anything that can reduce the number of unnecessary tests should surely be championed. A recent study from the Boston Medical Center (BMC) suggests that electronic medical record-based interventions can do just that.
The paper highlights how the hospital was able to not only reduce unnecessary diagnostic testing, but also increase the use of postoperative order sets, both of which are commonly used metrics that determine high-value medical care.
The team aimed to incorporate new recommendations from the Choosing Wisely campaign to reduce unnecessary medical tests into the electronic medical records to help alert providers on the best practice at specific times. After collecting data between July 2014 and December 2016, the team were able to observe a 3.1% drop in number of patients sent for pre-admission chest x-rays, with routine daily labs falling by 4%.
“The results from our interventions suggest that they alone show promise in improving high-value care, but using only an electronic medical record intervention may not be adequate to achieve optimal outcomes emphasized by Choosing Wisely,” the researchers say.
It was interesting to note that the intervention didn’t appear to have any impact on the estimated red blood cell transfusion utilization rate, or on the number of non-ICU urinary catheter days. In future, the researchers want to delve further into the topic to try and really hone in on what factors are most influential. For instance, do factors such as the education of the clinician, audits and feedback and peer comparison play a role in reducing unnecessary tests?
“In order to move the needle on reducing unnecessary healthcare costs, we need to consider multi-pronged approaches in order to engage providers in ways that can truly make a difference in how we deliver exceptional, high-value care to every patient,” the authors say.
For now however, it is perhaps worth considering the role that electronic medical records can play in that mission.
