Implementation of Best Practice Alert in an Electronic Medical Record to Limit Lower-Value Inpatient Echocardiograms

The American Journal of Cardiology
Adam FleddermannBethany A Austin

Abstract

There are increasing efforts nationally and at our institution to reduce lower-value care, including some use of imaging studies such as transthoracic echocardiography (TTE). In an effort to avoid repeating unnecessary studies on inpatients who recently underwent TTE, we implemented a best practice alert (BPA) in our electronic health record to notify ordering clinicians that a TTE had been performed in the past 6 months. The BPA requires the ordering clinician to acknowledge the alert and provide a reason for proceeding with the order and provides a link to ASE AUC criteria. Data on initial use were reviewed after approximately 6 months (February 16, 2017 to September 12, 2017.) This included review of the number of TTE orders removed, number reordered within the same day, subspecialty of ordering clinician, type of ordering clinician (MD vs NP, and so on), and length of stay in patients with orders that were confirmed versus removed. Independent t tests, Chi-square, and Fisher's exact tests were used for analysis. Over 209 days, the BPA triggered 3,226 times with 20% of these TTEs cancelled by the ordering clinician and remaining cancelled after 24 hours. There were no statistically significant differences in the proportion o...Continue Reading

Citations

Mar 10, 2019·The International Journal of Cardiovascular Imaging·Patrick M KozakAdam J Kingeter
Nov 19, 2020·Journal of Medical Internet Research·Philip von Wedel, Christian Hagist
May 19, 2021·Translational Vision Science & Technology·Xinxing GuoJudith E Goldstein

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