SARS-CoV-2 (also known as COVID-19) has been an unprecedented challenge in many parts of the medical field with blood banking being no exception. COVID-19 has had a distinctly negative effect on our blood collection nationwide forcing blood banks, blood centers, and the US government to adopt new policies to adapt to a decreased blood supply as well as to protect our donors from COVID-19. These policies can be seen distinctly in patient blood management and blood bank operations. We are also faced with developing policies and procedures for a nontraditional therapy, convalescent plasma; its efficacy and safety is still not completely elucidated as of yet.

Background: Among the variables that influence medical decisions, laboratory tests are considered to be among the most important and frequently used. The influence of laboratory tests on medical decisions has been difficult to estimate. The goal of this study was to estimate the number of patient encounters that included a laboratory test. Methods: We extracted information for 72 196 patient encounters from 1-week intervals each quarter of a year from our comprehensive academic medical center electronic medical record. The patients examined represent a comprehensive range of clinical conditions and medical services. We determined for which encounters laboratory and other orders existed. Results: Overall 35% of encounters had 1 or more laboratory tests ordered. However, the percent varied markedly with patient care areas. For inpatient, emergency department, and outpatient populations, 98%, 56%, and 29%, respectively, had 1 or more laboratory tests ordered. Conclusions: Our observations support that it is not possible to use a single number to categorize the frequency with which laboratory tests occur in patient encounters. Utilization of laboratory tests varied with type of medical service with almost all inpatients, approximately half of emergency department patients, and nearly one-third of outpatients having laboratory tests during their healthcare visit. IMPACT STATEMENT This investigation examined how frequently laboratory tests were included in the medical records of a large number of patients with a large mix of different clinical conditions. In addition, differences in frequency of ordering laboratory and other diagnostic tests in inpatient, outpatient, and emergency department care areas were examined. Consequently, the conclusions represent a comprehensive examination of how frequently laboratory and other diagnostic tests were available to inform medical decisions.

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