title: Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital.
abstract: OBJECTIVE
  To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing.
  
  
  METHODS
  The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.
  
  
  RESULTS
  Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged.
  
  
  CONCLUSIONS
  Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.
authors.affiliation: From the Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis Department of Dermatology, Indiana University School of Medicine, Indianapolis Department of Pathology, Richard L. Roudebush VA Medical Center, Indianapolis, IN rkonger@iupui.edu.
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Konger
authors.affiliation: From the Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis.
authors.forename: Paul
authors.initials: P
authors.lastname: Ndekwe
authors.affiliation: Department of Pathology, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Genea
authors.initials: G
authors.lastname: Jones
authors.affiliation: Department of Pathology & Laboratory Medicine, Syracuse, Syracuse VA Medical Center, Syracuse, NY.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Schmidt
authors.affiliation: Office of Information and Technology, Syracuse, Syracuse VA Medical Center, Syracuse, NY.
authors.forename: Marty
authors.initials: M
authors.lastname: Trey
authors.affiliation: Department of Pathology, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Baty
authors.affiliation: Department of Pathology, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Denise
authors.initials: D
authors.lastname: Wilhite
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis Department of Surgery, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Imtiaz A
authors.initials: IA
authors.lastname: Munshi
authors.affiliation: Department of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Sutter
authors.affiliation: Department of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Maddamsetti
authors.initials: M
authors.lastname: Rao
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis Department of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, IN.
authors.forename: Chowdry M
authors.initials: CM
authors.lastname: Bashir
mesh_terms: D064790:Clinical Laboratory Services / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D017046:Cost Savings; D006787:Hospitals, Veterans / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007753:Laboratories / Q000191:economics / Q000458:organization & administration; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: Clinical laboratory; Cost containment; Frequency filter; Test reduction; Utilization management