Validation and Implementation of an Ordering Alert to Improve the Efficiency of Monoclonal Gammopathy Evaluation

Abstract Objectives To evaluate the use of a provider ordering alert to improve laboratory efficiency and reduce costs. Methods We conducted a retrospective study to assess the use of an institutional reflex panel for monoclonal gammopathy evaluation. We then created a clinical decision support (CDS...

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Bibliographic Details
Published in:American journal of clinical pathology 2020-02, Vol.153 (3), p.396-406
Main Authors: Uljon, Sacha N, Simmons, Daimon P, Rudolf, Joseph W, Baron, Jason M, Dutta, Sayon, McEvoy, Dustin S, Murali, Mandakolathur, Dighe, Anand S
Format: Article
Language:English
Subjects:
Clinical pathology
Cost control
Cost Savings
Decision Support Systems, Clinical - economics
Diagnosis
Economic aspects
Efficiency
Electronic records
Electrophoresis
Humans
Laboratories
Medical Order Entry Systems
Medical protocols
Methods
Monoclonal gammopathies
Monoclonal gammopathy
Paraproteinemias - diagnosis
Practice Patterns, Physicians' - economics
Retrospective Studies
Serodiagnosis
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Summary:Abstract Objectives To evaluate the use of a provider ordering alert to improve laboratory efficiency and reduce costs. Methods We conducted a retrospective study to assess the use of an institutional reflex panel for monoclonal gammopathy evaluation. We then created a clinical decision support (CDS) alert to educate and encourage providers to change their less-efficient orders to the reflex panel. Results Our retrospective analysis demonstrated that an institutional reflex panel could be safely substituted for a less-efficient and higher-cost panel. The implemented CDS alert resulted in 79% of providers changing their high-cost order panel to an order panel based on the reflex algorithm. Conclusions The validated decision support alert demonstrated high levels of provider acceptance and directly led to operational and cost savings within the laboratory. Furthermore, these studies highlight the value of laboratory involvement with CDS efforts to provide agile and targeted provider ordering assistance.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqz180