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

Author:

Uljon Sacha N1,Simmons Daimon P2,Rudolf Joseph W3,Baron Jason M1,Dutta Sayon14,McEvoy Dustin S5,Murali Mandakolathur6,Dighe Anand S15

Affiliation:

1. Departments of Pathology, Massachusetts General Hospital, Boston

2. Department of Pathology, Brigham and Women’s Hospital, Boston, MA

3. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis

4. Emergency Medicine, Massachusetts General Hospital, Boston

5. Partners HealthCare, Somerville, MA

6. Medicine, Massachusetts General Hospital, Boston

Abstract

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.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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