OpenLabs services for ordering laboratory investigations

doi:10.1016/0169-2607(96)01742-N

Computer Methods and Programs in Biomedicine

Volume 50, Issue 2, July 1996, Pages 135-141

https://doi.org/10.1016/0169-2607(96)01742-N Get rights and content

Abstract

An automated system is described that screens requests for laboratory investigations from GPs and delivers feedback with respect to the adequacy of the requests. The system has to replace and extend the current system in which feedback is provided on a manual basis each half year, based on the tests requested during a period of one month, randomly selected from the previous half year. It has been reported elsewhere that the manual system reduced the number of tests requested considerably. The criteria used by the automated system and the manual system are based on guidelines and work agreements that GPs have agreed to follow when requesting investigations. It is concluded that the automated system is very user-friendly and that in the order of 4–17% of the requested tests could be identified as unnecessary, with a false negative rate in between 4% (for hyperthyroidism) and 23% (for hypothyroidism). The achieved reduction in the number of tests is in addition to the reduction obtained in the manual system.

References (16)

G.J.E. De Moor et al.
Towards a meta-syntax for medical EDI
Int. J. Biomed. Comput.
(1994)
A. Hasman et al.
To test or not to test, that is the question
Clinica Chimica Acta
(1993)
P.M.G. Broughton
Laboratory medicine in primary health care
Br. J. Gen. Practice
(1990)
R.G. Wones
Failure of low cost audits with feedback to reduce laboratory test utilization
Med. Care
(1987)
D.M. Berwick et al.
Feedback reduces test use in a health maintenance organization
J. Am. Med. Assoc.
(1986)
G.D. Everett
Impact of supervision by medical teachers and in patient test control programmes on the out-patient test utilization of residents
Med. Educ.
(1985)
J. Zaat
De macht der gewoonte, over de huisarts en zijn laboratoriumonderzoek
P. Pop et al.
A diagnostic center for general practitioners: results of individual feedback on diagnostic actions
J. Roy. Coll. Gen. Prac.
(1989)

There are more references available in the full text version of this article.

Cited by (5)

The use of expert systems for improving test use and enhancing the accuracy of diagnosis
2002, Clinics in Laboratory Medicine
A test ordering system with automated reminders for primary care based on practice guidelines
2000, International Journal of Medical Informatics
In this article we describe a real-time automated reminder system that has been developed to change Family Physicians’ (FP) test ordering behavior. The system focuses on the appropriateness of test requests. We aim at using the system as a substitute for written feedback by human experts. The reminder system consists of a knowledge base, an order entry system and modules to provide passive and active support in the form of reminders to FPs. The system generates critical comments about the rationality of the test requests at the moment the FP orders a test that is not in line with national or regional guidelines. For the first validation of the knowledge base we compared the comments of a human expert to the comments of the reminder system on three random samples of test requests. The overall agreement in the subsequent validation rounds was 46, 60 and 69%. The corrections made in the knowledge base after each validation round resulted in a reminder system with 149 reminders concerning various medical problems. Due to the corrections in the knowledge base the reminder system reacts better over the subsequent validation rounds.
Specifying an open clinical laboratory information system
1996, Computer Methods and Programs in Biomedicine
Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: Systematic reviews of the effects and cost-effectiveness of systems
2010, Health Technology Assessment
Pathology tests: Is the time for demand management ripe at last?
2003, Journal of Clinical Pathology

View full text

OpenLabs services for ordering laboratory investigations

Abstract

Int. J. Biomed. Comput.

Clinica Chimica Acta

Laboratory medicine in primary health care

Br. J. Gen. Practice

Failure of low cost audits with feedback to reduce laboratory test utilization

Med. Care

Feedback reduces test use in a health maintenance organization

J. Am. Med. Assoc.

Impact of supervision by medical teachers and in patient test control programmes on the out-patient test utilization of residents

Med. Educ.

De macht der gewoonte, over de huisarts en zijn laboratoriumonderzoek

A diagnostic center for general practitioners: results of individual feedback on diagnostic actions

J. Roy. Coll. Gen. Prac.