Patients in hospitals know there's a whole lot of testing going on in healthcare. Doctors know it, too, and researchers at top hospitals in the U.S. and Canada have been working on a plan to eliminate unnecessary medical testing. The idea is to cut medical bills in a way that actually improves patients' health at the same time.
The best way to begin to do this, the researchers, experts at Johns Hopkins University, the University of Virginia, the University of Michigan, the University of Toronto and the University of Pennsylvania, say, is get physicians and other care providers to reconsider their use of routine daily lab tests performed on hospitalized patients.
Calling this a “wasteful clinical practice that threatens the value of healthcare,” the researchers acknowledge that there are many reasons for excessive testing — from fear of being sued to a lack of awareness of the costs involved. Often, these tests are performed automatically, without determining whether they bring any value to the patient's treatment.
Blood tests are repeated many times during a patient's hospital stay and can lead to hospital-acquired anemia, increasing medical costs and generating more unnecessary testing.
Take blood tests. These are repeated many times during a patient's hospital stay. They can lead to hospital-acquired anemia, which increases medical costs and generates more unnecessary testing. These repetitive tests are also painful for patients who find themselves frequently being stuck with a needle.
The group's work is geared toward healthcare institutions, not individual doctors. They recommend that healthcare facilities begin by training those providing care — nurses to senior staff — to focus on care that is justified by its safety and effectiveness. If a test was not likely to improve the effectiveness of treatment, or posed a potential risk to a patient's health, it would not be ordered.
To give those ordering tests feedback on their ordering patterns, all testing at the facility would be audited and compared, anonymously, to the level of testing ordered by others. This would enable doctors and nurses to see how their patterns for ordering routine tests stack up to those of others and allow them to adjust their caregiving as needed.
Finally, to limit daily lab tests always done throughout a patient's stay, the power of electronic medical records could be harnessed to alert staff about tests that may well be unnecessary.