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The page below is a sample from the LabCE course Laboratory Effectiveness: Clinical Laboratory Utilization. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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The Electronic Medical Record (EMR) as a Utilization Tool

The Electronic Medical Record (EMR) is the software system that a medical organization uses to enter patient orders and information; it is the electronic version of the patient's medical chart. The EMR should not be confused with the laboratory information system (LIS), which interfaces with the EMR. The LIS is a different software package typically used only by laboratory staff.
The EMR can be a powerful tool for improving or guaranteeing good laboratory utilization. Clinicians may have preference lists, smart groups, or quick-panels that they build to streamline their ordering. Such lists will allow them to either order multiple tests with one click, or give them a limited list of only the tests they routinely use. For example, the preference list or short list of tests on an endocrinologist's screen might have TSH, free-T4, growth hormone, LH, FSH, and other hormone tests. However, none of these tests would likely be found on the preference list of an emergency room physician.
Periodically reviewing these lists is a good way to make sure that the right tests are grouped together and that inappropriate tests aren't available to some groups. UM teams can use the EMR to hide tests that should not be ordered by some clinicians. For example, you may decide that only the department of genetics can order BRCA testing for breast cancer (since it is a high-cost test that needs a consult), or you may decide that only allergists can order allergen testing. Another great example is 25-OH-vitamin-D. This is a commonly ordered test. However, 1,25-OH-vitamin-D is a very uncommon test that is really only useful to specialists in Endocrinology and perhaps Nephrology. If these two tests are listed together it is virtually guaranteed that some providers will order the wrong test. By 'hiding' the 1,25-OH-vitamin-D order so that only Endocrinology can see it, the risk of inappropriate ordering is greatly reduced.