The cost and quality of care are the focus of improvement initiatives happening at health systems across the country. Like imaging and other procedures, the necessity of laboratory testing, too, is being examined. Two recently published studies highlight how resident training and electronic medical record (EMR) order prioritization can impact potential overuse of laboratory testing. EMR Sequence Impacts Test Ordering Reprioritizing the sequence of test names in EMR laboratory order search results can reduce the overutilization of more expensive tests, according to a study published Sept. 22 in the American Journal of Clinical Pathology. A complete blood count (CBC) with leukocyte differential (CBC-DIFF) is frequently ordered in the emergency department, but the DIFF component of the test often does not impact clinical decision-making. Previous internal analysis at the Cleveland Clinic, showed that CBC-DIFF accounted for up to 98 percent of all CBC orders originating in the emergency department, compared with 53 percent of orders from the inpatient service. “Performing a slightly more expensive test that will not offer the provider any additional information may appear harmless in the short term but can easily result in a large waste in resources over time,” writes lead author Michael Phelan, M.D., from the […]