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Decrease in unnecessary vitamin D testing using clinical decision support tools: making it harder to do the wrong thing.


ABSTRACT: Objective:To evaluate the impact of clinical decision support (CDS) tools on rates of vitamin D testing. Screening for vitamin D deficiency has increased in recent years, spurred by studies suggesting vitamin D's clinical benefits. Such screening, however, is often unsupported by evidence and can incur unnecessary costs. Materials and Methods:We evaluated how rates of vitamin D screening changed after we implemented 3 CDS tools in the electronic health record (EHR) of a large health plan: (1) a new vitamin D screening guideline, (2) an alert that requires clinician acknowledgement of current guidelines to continue ordering the test (a "hard stop"), and (3) a modification of laboratory ordering preference lists that eliminates shortcuts. We assessed rates of overall vitamin D screening and appropriate vitamin D screening 6 months pre- and post-intervention. Results:Vitamin D screening rates decreased from 74.0 tests to 24.2 tests per 1000 members ( P ?

SUBMITTER: Felcher AH 

PROVIDER: S-EPMC7651907 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Decrease in unnecessary vitamin D testing using clinical decision support tools: making it harder to do the wrong thing.

Felcher Andrew H AH   Gold Rachel R   Mosen David M DM   Stoneburner Ashley B AB  

Journal of the American Medical Informatics Association : JAMIA 20170701 4


<h4>Objective</h4>To evaluate the impact of clinical decision support (CDS) tools on rates of vitamin D testing. Screening for vitamin D deficiency has increased in recent years, spurred by studies suggesting vitamin D's clinical benefits. Such screening, however, is often unsupported by evidence and can incur unnecessary costs.<h4>Materials and methods</h4>We evaluated how rates of vitamin D screening changed after we implemented 3 CDS tools in the electronic health record (EHR) of a large heal  ...[more]

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