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Is the Climb Worth the View? The Savings/Alert Ratio for Reducing Vitamin D Testing.
Hendrickson, Chase D; McLemore, Michael F; Dahir, Kathryn M; Just, Shari; Shajani-Yi, Zahra; LeGrand, Joseph; Lehmann, Christoph U; Weitkamp, Asli.
Afiliação
  • Hendrickson CD; Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • McLemore MF; Health Information Technology, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • Dahir KM; Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • Just S; Health Information Technology, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • Shajani-Yi Z; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • LeGrand J; Health Information Technology, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • Lehmann CU; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  • Weitkamp A; Health Information Technology, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Appl Clin Inform ; 11(1): 160-165, 2020 01.
Article em En | MEDLINE | ID: mdl-32102108
BACKGROUND: Despite guideline recommendations, vitamin D testing has increased substantially. Clinical decision support (CDS) presents an opportunity to reduce inappropriate laboratory testing. OBJECTIVES AND METHODS: To reduce inappropriate testing of vitamin D at the Vanderbilt University Medical Center, a CDS assigned providers to receive or not receive an electronic alert each time a 25-hydroxyvitamin D assay was ordered for an adult patient unless the order was associated with a diagnosis in the patient's chart for which vitamin D testing is recommended. The CDS ran for 80 days, collecting data on number of tests, provider information, and basic patient demographics. RESULTS: During the 80 days, providers placed 12,368 orders for 25-hydroxyvitamin D. The intervention group ordered a vitamin D assay and received the alert for potentially inappropriate testing 2,181 times and completed the 25-hydroxyvitamin D order in 89.9% of encounters, while the control group ordered a vitamin D assay (without receiving an alert) 2,032 times and completed the order in 98.1% of encounters, for an absolute reduction of testing of 8% (p < 0.001). CONCLUSION: This CDS reduced vitamin D ordering by utilizing a soft-stop approach. At a charge of $179.00 per test and a cost to the laboratory of $4.20 per test, each display of the alert led to an average reduction of $14.70 in charges and of $0.34 in spending by the laboratory (the savings/alert ratio). By describing the effectiveness of an electronic alert in terms of the savings/alert ratio, the impact of this intervention can be better appreciated and compared with other interventions.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina D / Sistemas de Apoio a Decisões Clínicas Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina D / Sistemas de Apoio a Decisões Clínicas Idioma: En Ano de publicação: 2020 Tipo de documento: Article