Placing test orders through the EHR's search engine may reduce overtesting, study finds

Limiting orders for gamma glutamyl transferase, an enzyme most commonly found in the liver, tests to only be made from the EHR search engine rather than from lists on the system's main screen can significantly reduce the number test orders made per month, according to a study published in the American Journal of Managed Care.

For the study, Tel Aviv (Israel) University researchers examined data on GGT test orders from Leumit Health Services in Israel from April 2014 to June 2015. The research team compared the number of GGT tests ordered at times during which the test orders were available on the main screen of the EHR system and when they were only available through the system's search engine function.

Results of the study showed that when the test orders could only be made through the search engine, the number of orders placed decreased from an average of 36,000 per month to 1,000 per month. When the GGT test option was added to just one place on the EHR's main screen, the number of tests ordered increased to 18,000 per month. The rise in number of orders continued to more than 35,000 tests ordered after the GGT test option was restored back to its usual place on all the lists.

The study authors concluded that while presenting test orders on a computerized list in the EHR can be convenient for busy clinicians and remove issues such as needing to search for a specific test, it can also make the decision to order tests "too easy," and can result in overtesting, according to the report. This can lead to possible overdiagnosis and overtreatment, the authors added.

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