The University of Utah's University Hospital could cut costs by as much as $1.5 million a year on its laboratory costs by using a software system intended to cut down on unnecessary testing, according to a study that was published in the most recent issue of the Journal of Hospital Medicine.
The analytical software reduced the mean cost of basic lab tests per patient day from $138 to $123, and from $618 to $558 if left unadjusted. Prior research has suggested that software design can have a direct impact on lab utilization and costs, according to the study.
The software focused on the reduction of commonplace laboratory testing, such as a basic metabolic panel, a comprehensive metabolic panel, complete blood counts, and an assay to check the level of prothrombin. The software provides physicians at the hospital with specific costs for each tests. Altogether, 6,310 patient admissions monitored by a hospitalist and the use of the software were compared to 25,586 visits without the hospitalist intervention.
Researchers found that interns were actually in charge of ordering most tests, and their relative lack of clinical experience led to them order more tests than what might have been necessary. Along with the use of the pricing software, the patient rounding process was also changed to involve more collaboration to determine if a test is necessary.
"Frequently, patients do need labs every morning, but that can create a culture where you're ordering tests without really thinking about what you're going to do with the results," study lead author Peter Yarbrough, M.D., an assistant professor of internal medicine who practices at the VA Salt Lake City Health Care System, said in a statement.
Laboratory testing has drawn more scrutiny in recent years. A 2015 Food and Drug Administration report concluded that unnecessary testing was driving up costs and also making diagnoses more difficult. Other studies have suggested that outreach to clinicians with education on their options can drive down unnecessary tests.