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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, Continued

The EMR can be used in many other ways to improve utilization (in addition to creating preference lists and smart-order sets for clinicians). The EMR can be used to:
  • Display the relative cost of the test. This not only helps clinicians to be mindful of resources, it also can help inform patients who may have co-pays or deductibles.
  • Direct the physician by way of a pop-up window to the proper test when questionable or obsolete tests are ordered. Example: if a physician tries to order MTHFR testing an alert could be made explaining that this testing is no longer considered medically useful.
  • Prohibit excessive order frequencies. Example: if an A1c was ordered three days ago, another provider cannot put in a new A1c order unless they override the warning or unless it is dated 30 days after the present order.
  • Alert a clinician who orders a test that is included on an previously ordered test panel that this test has already been ordered. Example: a hospitalist tries to order a serum creatinine. An alert informs the hospitalist that a basic metabolic panel was run four hours ago that included a creatinine.
  • Provide links to clinical guidelines or resources when a test is ordered (to help clinicians interpret the test or decide if it is the right test).
  • Provide reminders for certain tests (like PAP smear, lipids, A1c for diabetics, etc.). These can be programmed into the EMR so that needed lab tests get auto-ordered when patients meet date, age, or other criteria.
  • Look back in the patient record and make sure that once-in-a-lifetime genetic testing is not performed twice on the same patient.
As EMRs evolve in complexity and features, the potential for laboratory utilization management has greatly increased.