Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital

Am J Clin Pathol. 2016 Mar;145(3):355-64. doi: 10.1093/ajcp/aqv092. Epub 2016 Feb 18.


Objectives: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing.

Methods: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.

Results: Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged.

Conclusions: Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.

Keywords: Clinical laboratory; Cost containment; Frequency filter; Test reduction; Utilization management.

MeSH terms

  • Clinical Laboratory Services / economics
  • Clinical Laboratory Services / organization & administration
  • Clinical Laboratory Services / statistics & numerical data*
  • Cost Savings
  • Hospitals, Veterans / economics
  • Hospitals, Veterans / organization & administration*
  • Humans
  • Laboratories / economics
  • Laboratories / organization & administration
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • United States
  • United States Department of Veterans Affairs