The EMR can be used in many other ways to improve utilization (in addition to creating preference lists and smart-order sets for clinicians). The EMR can be used to:
- Display the relative cost of the test. This not only helps clinicians to be mindful of resources, it also can help inform patients who may have co-pays or deductibles.
- Direct the physician by way of a pop-up window to the proper test when questionable or obsolete tests are ordered. Example: if a physician tries to order MTHFR testing, an alert could be made explaining that this testing is no longer considered medically useful.
- Prohibit excessive order frequencies. Example: if an A1c was ordered three days ago, another provider cannot put in a new A1c order unless they override the warning or unless it is dated 30 days after the present order.
- Alert a clinician who orders a test that is included on a previously ordered test panel that this test has already been ordered. Example: a hospitalist tries to order a serum creatinine. An alert informs the hospitalist that a basic metabolic panel was run four hours ago that included a creatinine.
- Provide links to clinical guidelines or resources when a test is ordered (to help clinicians interpret the test or decide if it is the right test).
- Provide reminders for certain tests (like PAP smear, lipids, A1c for diabetics, etc.). These can be programmed into the EMR so that needed lab tests get auto-ordered when patients meet date, age, or other criteria.
- Look back in the patient record and make sure that once-in-a-lifetime genetic testing is not performed twice on the same patient.
As EMRs evolve in complexity and features, the potential for laboratory utilization management has greatly increased.
