Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital

Objectives: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. Methods: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and lab...

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Bibliographic Details
Published in:	American journal of clinical pathology Vol. 145; no. 3; pp. 355 - 364
Main Authors:	Konger, Raymond L., Ndekwe, Paul, Jones, Genea, Schmidt, Ronald P., Trey, Marty, Baty, Eric J., Wilhite, Denise, Munshi, Imtiaz A., Sutter, Bradley M., Rao, Maddamsetti, Bashir, Chowdry M.
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-03-2016
Subjects:	Clinical Laboratory Services - economics Clinical Laboratory Services - organization & administration Clinical Laboratory Services - statistics & numerical data Cost Savings Hospitals, Veterans - economics Hospitals, Veterans - organization & administration Humans Laboratories - economics Laboratories - organization & administration Length of Stay - economics Length of Stay - statistics & numerical data United States United States Department of Veterans Affairs Frequency filter Clinical laboratory Utilization management Cost containment Test reduction
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Summary:	Objectives: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. Methods: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.Results: Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Conclusions: Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-9173 1943-7722
DOI:	10.1093/ajcp/aqv092