title: What is the effect of electronic pathology ordering on test re-ordering patterns for paediatric patients?
abstract: Electronic ordering systems have the potential to enhance the efficient utilisation of pathology services. The aim of this study was to assess the effect of electronic pathology ordering on repeat test ordering for paediatric patients (ages 0 to 18 years) who were in intensive care units (ICUs) and non-ICU wards. The dataset described 85,728 pathology tests ordered for 5,073 children before and after the implementation of electronic ordering. This study showed that, for children in ICUs, the repeat test order rate was significantly lower for electronic orders than for paper-based orders. Similarly, the rate of repeat tests ordered within short intervals (up to 23-hours), for children older than one-year in non-ICU wards, was lower for electronic ordering than for paper ordering. The proportion of repeat tests occurring within one-hour of the previous test was consistently lower for tests ordered using electronic ordering than it was for tests ordered using the paper based system for patients older than one-year in all wards and for patients under one-year in ICUs. These results suggest that features of the electronic system, including alerts about previously ordered tests and the availability of information about previous orders, can help clinicians to identify and reduce unnecessary repeat tests.
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Georgiou
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
authors.forename: Elia
authors.initials: E
authors.lastname: Vecellio
authors.affiliation: South Eastern Area Laboratory Services Prince of Wales Hospital, NSW Health Pathology, Sydney, NSW, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Eigenstetter
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Toouli
authors.affiliation: South Eastern Area Laboratory Services Prince of Wales Hospital, NSW Health Pathology, Sydney, NSW, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Wilson
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
authors.forename: Johanna I
authors.initials: JI
authors.lastname: Westbrook
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002984:Clinical Laboratory Information Systems / Q000706:statistics & numerical data*; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D003584:Cytological Techniques / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D009517:New South Wales; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*