Study: Visual aids in EHRs cut nearly 50% of unintentional duplicate lab tests

Replacing an EHR alert with a visual aid can help decrease unintentional duplicate laboratory and radiology tests ordered by clinicians, according to a Dec. 2 study published in JAMA Network.

Beth Israel Deaconess Medical Center researchers developed a visual aid for EHRs that helps guide the clinician's eyes to the correct order action, instead of alerting the individual after he or she puts in a duplicate lab or test order.

The visual aid notifies a clinician that an order was previously placed during the emergency department patient's visit with the appearance of a red highlight around the checkbox of the particular order within the EHR's computerized provider entry system. For the study, the research team analyzed almost 185,000 ED patients' lab orders from Feb. 3, 2013, until Feb. 3, 2015, as well as radiology orders from Dec. 12, 2013, until Dec. 12, 2015.

Results of the study showed that after the noninterruptive nudge was deployed in the EHR, the rate of unintentional duplicate orders for lab tests decreased by 49 percent. The nudge also appeared to have affected the unintentional duplicate orders of radiology tests, which dropped 40 percent. Overall, the nudge eliminated approximately 17,936 clicks in the hospital's EHR.

While the visual aid was linked to reductions in lab and radiology test orders, the nudge did not present a significant change in unintentional duplicate orders of medications.

Study authors concluded that adding visual aids to EHRs may help reduce alert fatigue; the approach, which helps guide clinicians to the correct action instead of telling them they made an error, may also reduce clinician stress and burnout associated with EHRs, the study authors added.

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