title: Implementation of computerized add-on testing for hospitalized patients in a large academic medical center.
abstract: BACKGROUND
  Physician requests for additional testing on an existing laboratory specimen (add-ons) are resource intensive and generally require a phone call to the laboratory. Verbal orders such as these have been noted to be associated with errors in accuracy. The aim of this study was to compare a novel computerized system for add-on requests to the prior verbal system.
  
  
  METHODS
  We compare the computerized add-on request system to the verbal system with respect to order completeness and workflow.
  
  
  RESULTS
  We demonstrate that the computerized add-on system resulted in the complete in-laboratory documentation of the add-on request 100% of the time, compared to 58% with the verbal add-on system. In addition, we show that documentation of a verbal add-on request in the electronic medical record (EMR) occurred for 4% of requests, while in the computerized system EMR documentation occurred 100% of the time. We further demonstrate that the computerized add-on request process was well accepted by providers and did not significantly change the test mix of the add-on requests.
  
  
  CONCLUSIONS
  In computerized physician order entry (CPOE) implementations, add-on order functionality should be considered so these orders are documented in the EMR.
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Irina K
authors.initials: IK
authors.lastname: Kamis
authors.forename: Balaji
authors.initials: B
authors.lastname: Singh
authors.forename: Shalini
authors.initials: S
authors.lastname: Batra
authors.forename: Roberta H
authors.initials: RH
authors.lastname: Dixon
authors.forename: Anand S
authors.initials: AS
authors.lastname: Dighe
mesh_terms: D000046:Academic Medical Centers; D004282:Documentation; D006760:Hospitalization; D006801:Humans; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D014584:User-Computer Interface