Healthcare News & Insights

Keys to avoid repetitive lab testing in your hospital

New research from doctors at Johns Hopkins University and other organizations reveals repetitive lab testing for hospitalized patients is costly and unnecessary. Constant blood draws can also lead to hospital-acquired anemia and a variety of complications. 

A paper published last month in the JAMA Internal Medicine journal found that unnecessary blood draws can deplete a patient’s hemoglobin count, often leading to unnecessary repeat testing.

As a result, 20% of hospitalized patients can develop moderate to severe hospital-acquired anemia. This spiral may then lead to additional unnecessary tests, interventions and costs.

Impact on value & quality

The authors of the research are residents and faculty from the High Value Practice Academic Alliance (HVPAA), a consortium of more than 80 academic medical centers collaborating to lead large-scale improvements in health care value.

The paper notes that excessive lab tests can have an impact on the value of care hospitals provide. While the tests themselves don’t usually cost hospitals much money, the impact is far-reaching given that those tests influence nearly 60% to 70% of all medical decisions.

Plus, the minor costs of these tests do add up. Patients admitted to the hospital routinely undergo a battery of lab tests, even without medical justification. Payors usually only reimburse facilities for tests that have proven medical necessity, so hospitals would just eat the costs of any extra tests.

Many “routine” tests patients receive aren’t medically necessary, and according to Healthcare Finance News, decreasing daily lab testing doesn’t result in missed diagnoses or increase the number of readmissions to the hospital.

Stop unnecessary tests

Repetitive testing can result in harm associated with false positives, including excessive testing, overdiagnosis and overtreatment.

Some of the main reasons for overtreatment and overtesting in hospitals include:

  • habit
  • fear of doing too little and being sued
  • patient demands, and
  • financial incentives.

With such ingrained patterns for ordering repetitive tests and overtreating patients, it can be tricky to figure out a plan of action.

But the HVPAA report has two main recommendations:

  1. Design hospitalwide educational initiatives backed by data to outline and standardize best practices for lab tests and other treatments.
  2. Establish target numbers by which to reduce lab test orders, and provide instant feedback to providers ordering tests about their personal ordering patterns. That way, they’re aware of their own behavior and can break out of those habits.

Make sure your providers can justify the reasons for each and every lab test they’re ordering. If they can’t, there’s no need to perform the test – it’s just needlessly expensive and can hurt patients in the long run.

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