Lab Costs in the EHR May Decrease Number of Ordered Tests

Providing physicians with the real-time cost of lab tests in an electronic health record (EHR) system may help them reconsider ordering costly tests, the findings of a recent study reveal. 

Researchers from the Boston-based Massachusetts General Hospital's Division of General Medicine and the non-profit medical group alliance, Atrius Health in Newton, Mass looked at whether or not this kind of cost information in a lab test would prevent excessive testing. They looked at 215 primary care physicians working in the Atrius Health.

Those in an intervention group received real-time information on lab costs for 27 tests, while a controlled group did not. Changes  in the monthly laboratory ordering rate between the intervention and control groups were compared for 12 months before and six months after the intervention started. 

For those who had the costs of the tests displayed electronically in real-time, there was a significant decrease in the ordering rates for both high and low cost range tests. This included a significant decrease in ordering rates for four of the 21 lower cost laboratory tests, and one of six higher cost laboratory tests. A majority (81 percent) of physicians reported that the exercise increased their knowledge regarding costs of care and requesting real-time cost information on an expanded set of healthcare services.

“Our study demonstrates that electronic health records can serve as a tool to promote cost transparency, educate physicians and reduce the use of potentially unnecessary laboratory tests by integrating the relative cost of care into providers’ decision-making processes,” Thomas D. Sequist, M.D., MPH, of Atrius Health, the senior author on the study, said in a statement. “It’s like putting price labels on goods you buy in the supermarket. When you know the prices, you tend to buy more strategically.”