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Implementation of computerized add-on testing for hospitalized patients in a large academic medical center

  • Ji Yeon Kim , Irina K. Kamis , Balaji Singh , Shalini Batra , Roberta H. Dixon and Anand S. Dighe EMAIL logo
Published/Copyright: February 9, 2011
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 49 Issue 5

Abstract

Background: Physician requests for additional testing on an existing laboratory specimen (add-ons) are resource intensive and generally require a phone call to the laboratory. Verbal orders such as these have been noted to be associated with errors in accuracy. The aim of this study was to compare a novel computerized system for add-on requests to the prior verbal system.

Method: We compare the computerized add-on request system to the verbal system with respect to order completeness and workflow.

Results: We demonstrate that the computerized add-on system resulted in the complete in-laboratory documentation of the add-on request 100% of the time, compared to 58% with the verbal add-on system. In addition, we show that documentation of a verbal add-on request in the electronic medical record (EMR) occurred for 4% of requests, while in the computerized system EMR documentation occurred 100% of the time. We further demonstrate that the computerized add-on request process was well accepted by providers and did not significantly change the test mix of the add-on requests.

Conclusions: In computerized physician order entry (CPOE) implementations, add-on order functionality should be considered so these orders are documented in the EMR.

Keywords: clinical chemistry; laboratory management; order entry
Corresponding author: Anand S. Dighe, Massachusetts General Hospital, Bigelow Building, Room 510, 55 Fruit Street, Boston, MA 02114, USA Phone: +617-726-7902, Fax: +617-726-9206
Received: 2010-9-2
Accepted: 2010-12-16
Published Online: 2011-02-09
Published in Print: 2011-05-01

©2011 by Walter de Gruyter Berlin New York

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https://doi.org/10.1515/CCLM.2011.140
Keywords for this article
clinical chemistry; laboratory management; order entry

Articles in the same Issue

  1. Editorials
  2. Laboratory testing and/or monitoring of the new oral anticoagulants/antithrombotics: for and against?
  3. Circulating macrocomplexes: old wine in new bottles?
  4. Review
  5. Laboratory assessment of new anticoagulants
  6. Minireviews
  7. Biomarkers in Alzheimer’s disease
  8. Analytical variability in sport hematology: its importance in an antidoping setting
  9. The plodding diagnosis of monogenic autoinflammatory diseases in childhood: from the clinical scenery to laboratory investigation
  10. Opinion Paper
  11. Collective opinion paper on findings of the 2010 convocation of experts on laboratory quality
  12. Genetics and Molecular Diagnostics
  13. Genetic variability of the fructosamine 3-kinase gene in diabetic patients
  14. Identification of Bcl-2/IgH fusion sequences using real-time PCR and chip-based microcapillary electrophoresis
  15. Performance evaluation of a multiplex assay for future use in biomarker discovery efforts to predict body composition
  16. Pharmacogenetics of tacrolimus after renal transplantation: analysis of polymorphisms in genes encoding 16 drug metabolizing enzymes
  17. General Clinical Chemistry and Laboratory Medicine
  18. Quality Indicators in Laboratory Medicine: from theory to practice
  19. Implementation of computerized add-on testing for hospitalized patients in a large academic medical center
  20. Human growth hormone (GH) immunoassay: standardization and clinical implications
  21. Coagulation assays based on the Luminescent Oxygen Channeling Immunoassay technology1)
  22. Trefoil factor family peptides in human saliva and cyclical cervical mucus. Method evaluation and results on healthy individuals
  23. Steroid binding properties of the 2nd WHO International Standard for sex hormone-binding globulin
  24. Thyroxin overdose due to rheumatoid factor interferences in thyroid-stimulating hormone assays
  25. Cancer Diagnostics
  26. Quantification of HER2 autoantibodies in the amplification phenomenon of HER2 in breast cancer
  27. Glycosylation of proteins in healthy and neoplastic human salivary glands – a preliminary study
  28. Infectious Diseases
  29. Quantification of cerebrospinal fluid lactic acid in the differential diagnosis between HIV chronic meningitis and opportunistic meningitis
  30. Cardiovascular Diseases
  31. Carotid restenosis is associated with plasma ADMA concentrations in carotid endarterectomy patients
  32. High concentrations of asymmetric dimethylarginine are associated with ST-segment resolution failure after reperfusion for acute myocardial infarction
  33. An increase in serum uric acid concentrations is associated with an increase in the Framingham risk score in Korean adults
  34. The effect of a one-year weight reduction program on serum uric acid in overweight/obese children and adolescents
  35. False positive troponin result caused by a true macrotroponin
  36. Letters to the Editor
  37. Patient safety: patient identification wristband errors
  38. Prevalence of hemolytic specimens referred for arterial blood gas analysis
  39. “Triage” of lymphoid malignancies in the peripheral blood using the Extended Immunofluorescent Application of the CELL-DYN Sapphire automated hematology analyzer
  40. Presepsin (sCD14-ST): development and evaluation of one-step ELISA with a new standard that is similar to the form of presepsin in septic patients
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