Laboratory utilization improvement through a computer-aided algorithm developed with general practitioners

Salinas, María; López-Garrigós, Maite; Asencio, Alberto; Leiva-Salinas, Maria; Lugo, Javier; Leiva‐Salinas, Carlos

doi:10.1515/cclm-2014-0762

Cited by 27 publications

(23 citation statements)

References 9 publications

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“…Of the most successful interventions in laboratory test utilization management are those that combine various tools. Indeed for its maintenance over time computer-aided algorithms ( 14 ) are crucial, being education a key tool in the laboratory test utilization management toolbox ( 13 ). …”

Section: Discussionmentioning

confidence: 99%

Education and communication is the key for the successful management of vitamin D test requesting

et al. 2015

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IntroductionPre-preanalytical and post-postanalytical phases are steps where the laboratory professional may play a crucial role. Measuring the serum circulating 25 hydroxyvitamin D level (25(OH)D) is recommended to evaluate vitamin D status in patients at risk for vitamin D deficiency while 1,25 hydroxyvitamin D (1,25(OH)2D) is only recommended to monitor several particular conditions (chronic kidney disease, hereditary phosphate-losing disorders, and some other) clearly defined by the current clinical guidelines of Endocrine Society. Our research hypothesis was that through education and communication through comments in the Laboratory Information System (LIS), we could improve appropriateness in the request vitamin D tests.Materials and methodsA retrospective observational cross-sectional study was conducted from January 2005 to December 2014. Each 1,25(OH)2D request was reviewed individually by a member of the laboratory staff. Starting in November 2011, each inappropriate 1,25(OH)2D request was registered in LIS and 25(OH)D was measured instead of 1,25(OH)2D. We counted the overall number of 1,25(OH)2D requests and the number of inappropriate requests which then were marked with a comment.ResultsThe request of 25(OH)D increased along years. However, 1,25(OH)2D requests increased until 2012 when demand began to diminish.ConclusionsEducation and communication through comments in the LIS, corrected the inappropriate request of 1,25(OH)2D and promoted the use of 25(OH)D to study vitamin D deficiency.

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Section: Discussionmentioning

confidence: 99%

Education and communication is the key for the successful management of vitamin D test requesting

et al. 2015

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“…Furthermore, requests for transferrin and iron testing are somewhat different between AACCs. Such differences suggest that transferrin testing may also be over-requested in primary care in Spain, and that strategies based on computer-aided algorithms to remove transferrin testing when requested simultaneously with ferritin testing28 should be developed by GPs, and the protein monitored through process indicators29 such as transferrin/ferritin. Our results show that more than €1.5 million could have been saved if transferrin and iron test requests reached the levels in the AACC with best practice, and more than €2.5 million if extrapolated to the whole Spanish population.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, it can be the cause of poor development outcome in childhood and adolescents 31. In conclusion, implementation of strategies to correct inappropriate ferritin test requesting, through algorithms,28 by measuring ferritin only when haemoglobin and MCV values are low is not advisable, since iron deficiency without anaemia is a more prevalent condition and it is very important for it to be detected. However, efforts to improve ferritin test requesting should be made through interdepartmental communication and cooperation 32…”

Section: Discussionmentioning

confidence: 99%

Primary care requests for anaemia chemistry tests in Spain: potential iron, transferrin and folate over-requesting

et al. 2017

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“…In fact, in the year 2015 less than 20% of requests from primary care did not include the pertinent clinical information. There are probably multiple causes for this improvement and it is possible that communication and education ( 7 ), as in other stages of laboratory total testing process ( 8 - 10 ), could have contributed to the improvement of GPs awareness for a better request completion.…”

Section: Discussionmentioning

confidence: 99%

Indications for laboratory tests in primary care: assessment of the most frequent indications and requests with blank clinical information

et al. 2016

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IntroductionThe aim of this work is twofold. Firstly, to study the temporal evolution in the number of laboratory requests from primary care without clinical indication, and to analyse the number of such requests before and after the implementation of an automated requesting procedure. Secondly, to investigate what are the most frequent clinical indications that prompted laboratory testing.Materials and methodsThis is a retrospective observational study conducted from January 2009 to December 2015. We counted the requests without clinical question, calculated the number of such requests per total number of requests and listed the most frequent indications.ResultsThe number of tests requests with a blank clinical indication was significantly higher in 2009 when compared to 2015 (80% vs. 20%; P < 0.001). For every year in this 7-year period, dyslipidemia, essential hypertension and diabetes were the most prevalent diagnoses that prompted a laboratory test in primary care, accounting for more than 20% of all indications.ConclusionsThe number of primary care requests without patient clinical question has decreased after the implementation of an automated requesting procedure. Disorders of lipid metabolism, essential hypertension and diabetes mellitus were the most prevalent diagnoses that prompted a laboratory test in primary care.

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Laboratory utilization improvement through a computer-aided algorithm developed with general practitioners

Abstract: The strategies designed between the laboratory and the requesting clinicians and automatically established by using our laboratory information system were successful.

Cited by 27 publications

References 9 publications

Education and communication is the key for the successful management of vitamin D test requesting

Education and communication is the key for the successful management of vitamin D test requesting

Primary care requests for anaemia chemistry tests in Spain: potential iron, transferrin and folate over-requesting

Indications for laboratory tests in primary care: assessment of the most frequent indications and requests with blank clinical information

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