Software design can affect lab tests ordered

Modifying the software list of lab tests for a particular condition can affect the number and relevance of those ordered, according to research from the University of Missouri.

Victoria Shaffer, an assistant professor of health sciences in the MU School of Health Professions, and her team focused on three configurations in the same electronic medical system: an opt-in version in which no lab tests were pre-selected, an opt-out version in which physicians had to de-select lab tests they believed were not clinically relevant, and one with a few tests pre-selected based on recommendations by pediatric experts.

They found that doctors using the opt-out version ordered three more tests than with the opt-in or recommended versions. However, more tests were ordered with the recommended lists than with the opt-in design. The opt-out and recommended versions produced more clinically relevant tests, according to Shaffer, though use of the opt-out method also cost 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 said in an announcement.

Shaffer said it's vital for software designers to work with clinical users to create optimal products.

"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," she said.

Americans are paying more healthcare costs out of their own pockets, according to a recent report from the Health Care Cost Institute, with lab tests among the drivers of that expense.

The potential to eliminate duplicate tests has been a cornerstone among the arguments for adopting EHRs. A study from the University of Michigan and elsewhere, meanwhile, found that adoption of electronic records can curb outpatient costs, with most of the savings coming from radiology.

The Office of the Inspector General, meanwhile, recently reported that Medicare could have saved $910 million--38 percent--on lab test payments if it would have paid providers at the lowest established rate in each geographic area.

To learn more:
- find the research
- here's the announcement

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