Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice
Background Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase. Objective To...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BCS, The Chartered Institute for IT
2017-10-01
|
| Series: | Journal of Innovation in Health Informatics |
| Subjects: | |
| Online Access: | https://hijournal.bcs.org/index.php/jhi/article/view/907 |
| _version_ | 1818196357852168192 |
|---|---|
| author | Cassie Jaeger Paul Sullivan James Waymack David Griffen Griffen |
| author_facet | Cassie Jaeger Paul Sullivan James Waymack David Griffen Griffen |
| author_sort | Cassie Jaeger |
| collection | DOAJ |
| description | Background Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase.
Objective To reduce unnecessary diagnostic testing in acute pancreatitis.
Methods The pre-checked amylase test within the Emergency Department’s Computerized Provider Order Entry (CPOE) abdominal pain order set was changed to an un-checked state, but kept as an option to order with a single click. Amylase testing, lipase testing and cost were measured for one year pre and post intervention.
Results Simple de-selection intervention reduced redundant amylase testing from 71% to 9%, resulting in a percent of decrease of 87% and an annualized saving of approximately $719,000 in charges.
Conclusion CPOE de-selection is an effective tool to reduce non-value added activity and reduce cost while maintaining quality patient care and physician choice. |
| first_indexed | 2024-12-12T01:32:48Z |
| format | Article |
| id | doaj.art-d71d78c3e34940ad97d118dac784c094 |
| institution | Directory Open Access Journal |
| issn | 2058-4555 2058-4563 |
| language | English |
| last_indexed | 2024-12-12T01:32:48Z |
| publishDate | 2017-10-01 |
| publisher | BCS, The Chartered Institute for IT |
| record_format | Article |
| series | Journal of Innovation in Health Informatics |
| spelling | doaj.art-d71d78c3e34940ad97d118dac784c0942022-12-22T00:42:56ZengBCS, The Chartered Institute for ITJournal of Innovation in Health Informatics2058-45552058-45632017-10-0124310.14236/jhi.v24i3.907831Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choiceCassie Jaeger0Paul Sullivan1James Waymack2David Griffen Griffen3Southern Illinois University, School of Medicine, Center for Clinical Research, SpringfieldCLSSBB Laboratory Quality & Safety, Memorial Medical Center, SpringfieldDivision of Emergency Medicine, Department of Surgery, School of Medicine, Southern Illinois University, and Department of Emergency Medicine, Memorial Medical Center, SpringfieldDivision of Emergency Medicine, Department of Surgery, School of Medicine, Southern Illinois University, and Department of Emergency Medicine, Memorial Medical Center, SpringfieldBackground Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase. Objective To reduce unnecessary diagnostic testing in acute pancreatitis. Methods The pre-checked amylase test within the Emergency Department’s Computerized Provider Order Entry (CPOE) abdominal pain order set was changed to an un-checked state, but kept as an option to order with a single click. Amylase testing, lipase testing and cost were measured for one year pre and post intervention. Results Simple de-selection intervention reduced redundant amylase testing from 71% to 9%, resulting in a percent of decrease of 87% and an annualized saving of approximately $719,000 in charges. Conclusion CPOE de-selection is an effective tool to reduce non-value added activity and reduce cost while maintaining quality patient care and physician choice.https://hijournal.bcs.org/index.php/jhi/article/view/907amylasecost analysiscomputerized physician order entry system |
| spellingShingle | Cassie Jaeger Paul Sullivan James Waymack David Griffen Griffen Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice Journal of Innovation in Health Informatics amylase cost analysis computerized physician order entry system |
| title | Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice |
| title_full | Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice |
| title_fullStr | Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice |
| title_full_unstemmed | Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice |
| title_short | Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice |
| title_sort | effectively reducing amylase testing using computer order entry in the emergency department quality improvement without eliminating physician choice |
| topic | amylase cost analysis computerized physician order entry system |
| url | https://hijournal.bcs.org/index.php/jhi/article/view/907 |
| work_keys_str_mv | AT cassiejaeger effectivelyreducingamylasetestingusingcomputerorderentryintheemergencydepartmentqualityimprovementwithouteliminatingphysicianchoice AT paulsullivan effectivelyreducingamylasetestingusingcomputerorderentryintheemergencydepartmentqualityimprovementwithouteliminatingphysicianchoice AT jameswaymack effectivelyreducingamylasetestingusingcomputerorderentryintheemergencydepartmentqualityimprovementwithouteliminatingphysicianchoice AT davidgriffengriffen effectivelyreducingamylasetestingusingcomputerorderentryintheemergencydepartmentqualityimprovementwithouteliminatingphysicianchoice |