How EMR interventions helped Boston Medical Center cut unneeded testing

After launching EMR-based interventions, Boston Medical Center reduced unneeded diagnostic testing and labs ordered — two markers of high quality care — a study published in the Joint Commission Journal on Quality and Patient Safety found.

To improve care, Boston Medical Center focused on several recommended areas in the Choosing Wisely campaign, an American Board of Internal Medicine Foundation initiative that aims to increase dialogue on avoiding unnecessary medical tests, treatments and procedures. The areas included the overutilization of chest X-rays and routine daily labs.

To limit the use of these procedures, the researchers worked with the hospital's IT team to incorporate new recommendations into EMRs that alert providers to best practice information.

Six months after the hospital's intervention, the portion of patients getting chest X-rays before admission declined significantly, at 3.1 percent. And the number of labs ordered at routine times decreased 4 percent.

"The results from our interventions suggest that they alone show promise in improving high value care, but using only an electronic medical record intervention may not be adequate to achieve optimal outcomes emphasized by Choosing Wisely," said corresponding study author Nicholas Cordella, MD.

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