Enhanced cosyntropin stimulation test performance enabled by electronic medical record.
OBJECTIVE
To improve performance of the cosyntropin stimulation test (CST) used for diagnosis of adrenal-cortisol insufficiency by implementing an electronic medical record (EMR) system protocol.


METHODS
We implemented a SmartForm protocol of the validated CST in our EMR system (CS-Link™, EPIC) system and compared medical staff test performance before and after protocol implementation.


RESULTS
Correct performance of the CST improved significantly after EMR implementation. The number of correctly performed CSTs increased from 16.1 % before to 53.5 % after implementation (p < 0.0001) while those performed incorrectly and were uninterpretable decreased from 36.2 to 7.1 % (p < 0.0001). This performance improvement result in a calculated cost savings of $50,414 for every 100 tests performed.


CONCLUSIONS
The EMR system is useful for guiding medical staff to accurately perform the CST, reduce the number of wasted tests, and maximize staff time and resources.
Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Davis Building, Room 3021, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA. anat.benshlomo@cshs.org.
Anat
A
Ben-Shlomo
Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Davis Building, Room 3021, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
Joseph
J
Guzman
Biostatistics Core, Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
James
J
Mirocha
D000304:Adrenal Cortex Function Tests / Q000592:standards*; D002985:Clinical Protocols; D003366:Cosyntropin; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male
D003366:Cosyntropin
Adrenal cortisol insufficiency; Cosyntropin stimulation test; Electronic medical record; Performance improvement