Doctors order fewer treatments when forced to justify them, leading to better care overall. Study from #BostonUniversity showed that simply requiring #physicians to justify test ordering in the EMR cut the amount of testing by more than half with no discernible decrease in #quality. #healthcarequality #healthcarecosts #valuebasedcare #patientcenteredcare
A very important idea indeed! While mentoring students during my postgrad studies, I always asked them about the aims of their tests and usually that let us cancel around 20-30% of initially planned tests without loosing any relevant information on the case. But that brings another important issue, which was certainly a serious pain for us in the context of everyday practice - a lot of medical records soft is not very intuitive and comfortable. Every justification takes extra time, which is okay if you are a student and work with just a few patients in your first months of practice, but it becomes rather painful when you need to be fast and do it for tens of patients in between many other important tasks. I, for one, have never met a really user-friendly interface which made me faster and more effective instead of slowing me down and requiring extra RAM in my head.
That was a very interesting study and seemed very well controlled except for a few really, really critical factors that were missed: The patients were 4x sicker at the control hospital with higher ESI scores and the patients were 4x more likely to be seen by a resident at the control hospital. Trainees. Order. More. Tests. Sicker. Patients. Get. More. Tests. (Also, it's from 2009; arguably nowadays many emergency physicians are just doing their own POCUS ultrasounds as part of their physical exam.)
Good news. Revamping our legal system with regards to malpractice would also help with this.
Ajay Perumbeti
8mo
Thanks for sharing, and they did the hard work. Good to highlight problem scoping by providing data to providers and leveraging provider intuition is worth the time. We need speed thereafter. Look forward to Living CDS with CDS elements done in a Day: build, deploy, test, monitor, and retire.
Testing was definitely reduced as burnt out doctors are tired of fighting and being told to do more with less!
So I assume they followed for life expectancy without the tests?
Chief Medical Officer & Healthcare Strategist 86Borders
8moAlso seems like a recipe for more burnout