More on Quality and Safety

An ambitious plan to slash needless medical testing has emerged

By giving healthcare providers real-time feedback on their ordering patterns, they can adjust those patterns to optimize care.

Jeff Lagasse, Associate Editor

Researchers at top hospitals in the U.S. and Canada have developed an ambitious plan to eliminate unnecessary medical testing, with the goal of reducing medical bills while improving patient outcomes, safety and satisfaction.

The researchers are urging physicians and other care providers to reconsider the use of routine daily lab tests performed on hospitalized patients. Automatically performing such tests without determining they are important to the patient's treatment is a "wasteful clinical practice that threatens the value of healthcare," the researchers warn in a new paper published in JAMA Internal Medicine, a journal of the American Medical Association.

[Also: Unnecessary medical tests, treatments cost $200 billion annually, cause harm]

They note, for example, that excessive blood testing can lead to hospital-acquired anemia, increase medical costs and generate additional unnecessary testing. It's also painful for the patients who find themselves frequently being stuck with a needle.

Citing strong evidence of the negative effects of routine, daily laboratory testing, the analysis called the reduction of such testing a "high-value" quality improvement effort.

There are many reasons for excessive testing, from fear of litigation to lack of knowledge of the costs involved. However, the paper suggests that there are simple ways for healthcare facilities to reduce unnecessary testing safely and without compromising the quality of patient care. Several previous studies have borne this out, they said.

"Although reducing repetitive laboratory testing may bend the cost curve, patient safety should remain at the forefront of these efforts," the researchers wrote.

The plan encourages healthcare facilities to design and implement educational efforts to train care providers in better practices. Evidence should be provided that demonstrates the safety and effectiveness of those practices, they said. This educational effort should range from bedside nurses all the way up through senior hospital leadership.

The report encourages the auditing of testing, and providing feedback to those ordering the tests. By giving healthcare providers real-time feedback on their ordering patterns, they can adjust those patterns to optimize care. Anonymized comparative data should be provided as well, the authors said.

Electronic medical records can also be harnessed to limit unnecessary testing -- for example, hospitals might limit the ability to order repetitive daily labs on a perpetual basis.

The researchers' efforts align with the University of Virginia Health System's Be Safe initiative, which calls on physicians and hospital leaders to develop and consistently adhere to best practices that put the patient first.

Twitter: @JELagasse
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