title: Implementation of point-of-care testing in an ambulatory practice of an academic medical center.
abstract: OBJECTIVE
  Point-of-care laboratory testing (POCT) offers reduced turnaround time and may promote improved operational efficiency. Few studies have been reported that document improvements from implementing POCT in primary care.
  
  
  METHODS
  We measured metrics of practice efficiency in a primary care practice before and after implementation of POCT, including the total number of tests ordered, letters and phone calls to patients, and revisits due to abnormal test results. We performed a cost and revenue analysis.
  
  
  RESULTS
  Following implementation of POCT, there was a 21% decrease in tests ordered per patient (P < .0001); a decrease in follow-up phone calls and letters by 89% and 85%, respectively (P < .0001 and P < .0001); and a 61% decrease in patient revisits (P = .0002). Estimated testing revenues exceeded expenses by $6.62 per patient, and potential cost savings from improved efficiency were $24.64 per patient.
  
  
  CONCLUSIONS
  POCT can significantly improve clinical operations with cost reductions through improved practice efficiency.
authors.affiliation: From the Departments of Medicine and Harvard Medical School, Boston, MA.
authors.forename: J Benjamin
authors.initials: JB
authors.lastname: Crocker
authors.affiliation: Pathology, Massachusetts General Hospital, Boston, and Harvard Medical School, Boston, MA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lee-Lewandrowski
authors.affiliation: From the Departments of Medicine and.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lewandrowski
authors.affiliation: Pathology, Massachusetts General Hospital, Boston, and Harvard Medical School, Boston, MA.
authors.forename: Jason
authors.initials: J
authors.lastname: Baron
authors.affiliation: Pathology, Massachusetts General Hospital, Boston, and.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Gregory
authors.affiliation: Pathology, Massachusetts General Hospital, Boston, and Harvard Medical School, Boston, MA. klewandrowski@partners.org.
authors.forename: Kent
authors.initials: K
authors.lastname: Lewandrowski
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D000328:Adult; D000553:Ambulatory Care / Q000191:economics*; D017046:Cost Savings; D004526:Efficiency; D006801:Humans; D007755:Laboratories, Hospital / Q000191:economics*; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000191:economics*
keywords: Comprehensive metabolic panel; Cost-effectiveness; Hemoglobin A1c; Lipid panel; Point-of-care testing; Practice efficiency; Primary care