Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center

BMC Med Inform Decis Mak. 2015 Feb 22;15:11. doi: 10.1186/s12911-015-0137-7.


This case study over time describes five years of experience with interventions to improve laboratory test utilization at an academic medical center. The high-frequency laboratory tests showing the biggest declines in order volume post intervention were serum albumin (36%) and erythrocyte sedimentation rate (17%). Introduction of restrictions for 170 high-cost send-out tests resulted in a 23% decline in order volume. Targeted interventions reduced mis-orders involving several "look-alike" tests: 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D; manganese, magnesium; beta-2-glycoprotein, beta-2-microglobulin. Lastly, targeted alerts reduced duplicate orders of germline genetic testing and orders of hepatitis B surface antigen within 2 weeks of hepatitis B vaccination.

MeSH terms

  • Academic Medical Centers / standards*
  • Clinical Laboratory Techniques / statistics & numerical data*
  • Electronic Health Records / standards*
  • Humans
  • Practice Patterns, Physicians' / standards*
  • Quality Improvement / standards*