The Promise-and Pitfalls-of Computerized Provider Alerts for Laboratory Test Ordering

It is no secret that laboratory tests are overordered in the clinical environment; a recent metaanalysis demonstrated that tests are overused by 20.6% on average. The ordering of unnecessary tests on such a massive scale may impact not only direct healthcare costs, but also patient safety, and may lead to unnecessary follow-up investigation and iatrogenic blood loss due to excess phlebotomy. Unfortunately, in large hospitals with high patient volumes, it would be impractical for laboratory directors to evaluate every test individually for appropriateness, and even more difficult to convince providers to change ordering practices. Meeting other evidence-based quality objectives in laboratory ordering is similarly labor-intensive.