A minimalist electronic health record-based intervention to reduce standing lab utilisation

Background Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive. Objective To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation. Setting One year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU). Intervention Providers were required to specify the number of times each test should occur instead of being able to order them indefinitely. Measurements For eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured. Results Utilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU. Conclusions Requiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.

Automated summary

Requiring providers to specify the number of occurrences of labs significantly reduces utilization in some cases.