Programming a hospital's EHR with clinical decision support for gastrointestinal testing can decrease inappropriate testing by 46 percent, according to a study published in Infection Control & Hospital Epidemiology.
Omaha-based University of Nebraska researchers implemented clinical decision support tools into a Midwest-based 870-bed tertiary hospital's Epic EHR to provide alerts, as well as a hard stop, to prevent unnecessary orders for gastrointestinal pathogen panel test. The GIPP is a test that detects 22 disease-causing organisms, and it is used for new patients who may have been exposed to various pathogens. However, the test is considered unnecessary for most patients if it has already been used or is performed later in their hospital stay.
In July 2015, the hospital implemented the GIPP for patients with 63 diarrhea illnesses as a replacement to the traditional stool culture. The GIPP was performed daily at the hospital. Then, in April 2017, researches implemented the hard stop tool to the EHR. The CDS tools provided guidance on appropriate use and alternative testing as well as the hard stop, which prohibited the ability to order duplicate testing and tests in patients hospitalized for less than 72 hours.
Results of the study showed that 21.5 percent of the GIPP tests ordered were found to be unnecessary prior to activation of the hard stop within the EHR. After the CDS tools were added to the EHR, only 4.9 percent of GIPP tests were unnecessary.
Researchers concluded that CDS within the EHR reduced testing by 46 percent, which translates to a potential savings of $168,000 in unnecessary test costs. The cost savings factor in the cost of alternative testing.
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