• Kuo-Kai Chin, Amrita Krishnamurthy, Talhah Zubair, Tara Ramaswamy, Jason Hom, Paul Maggio, and Lisa Shieh.
• Stanford University School of Medicine, Stanford, California, USA.
• Postgrad Med J. 2021 Feb 1; 97 (1144): 97-102.

BackgroundRepetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive.ObjectiveTo evaluate the effect of a minimally restrictive EHR-based intervention on utilisation.SettingOne year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU).InterventionProviders were required to specify the number of times each test should occur instead of being able to order them indefinitely.MeasurementsFor eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured.ResultsUtilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU.ConclusionsRequiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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