The Impact of an Electronic Expensive Test Notification

Am J Clin Pathol. 2018 Apr 25;149(6):530-535. doi: 10.1093/ajcp/aqy021.

Abstract

Objectives: The impact of clinical decision support tools (CDSTs) that display test cost information has been variable.

Methods: We retrospectively analyzed the 3-year impact of a passive CDST that notified providers when the test order cost was $1,000 or more. We determined the most common expensive tests ordered, the frequency with which providers abandoned the order after notification, and the costs saved through this intervention.

Results: The average monthly abandonment rate was 12.5% (2014), 12.9% (2015), and 14.3% (2016). The cost savings from tests not performed for this 3-year period was $696,007. Molecular hematopathology assays were the most frequently ordered tests, with variable abandonment rates.

Conclusions: Although this CDST was passive (ie, could be overridden at the point of order entry) and was associated with a relatively low abandonment rate, it achieved a considerable cost savings each year since each abandoned test saved the institution $1,000 or more.

MeSH terms

  • Cost Savings / statistics & numerical data*
  • Decision Support Systems, Clinical / economics*
  • Diagnostic Tests, Routine / economics*
  • Diagnostic Tests, Routine / statistics & numerical data
  • Humans
  • Retrospective Studies