Cleveland Clinic, Cleveland, OH.
Am J Clin Pathol. 2018 Apr 25;149(6):530-535. doi: 10.1093/ajcp/aqy021.
The impact of clinical decision support tools (CDSTs) that display test cost information has been variable.
We retrospectively analyzed the 3-year impact of a passive CDST that notified providers when the test order cost was $1,000 or more. We determined the most common expensive tests ordered, the frequency with which providers abandoned the order after notification, and the costs saved through this intervention.
The average monthly abandonment rate was 12.5% (2014), 12.9% (2015), and 14.3% (2016). The cost savings from tests not performed for this 3-year period was $696,007. Molecular hematopathology assays were the most frequently ordered tests, with variable abandonment rates.
Although this CDST was passive (ie, could be overridden at the point of order entry) and was associated with a relatively low abandonment rate, it achieved a considerable cost savings each year since each abandoned test saved the institution $1,000 or more.
显示检验成本信息的临床决策支持工具（CDST）的影响各不相同。
我们回顾性分析了一种被动 CDST 的 3 年影响，该工具在检验订单费用达到 1000 美元或更高时通知提供者。我们确定了最常订购的昂贵检验，以及在通知后提供者放弃订单的频率，以及通过这种干预措施节省的成本。
平均每月放弃率分别为 12.5%（2014 年）、12.9%（2015 年）和 14.3%（2016 年）。在这 3 年期间，由于未进行这些检验而节省的成本为 696007 美元。分子血液病理学检测是最常订购的检验，其放弃率各不相同。
尽管这种 CDST 是被动的（即可以在订单输入点被覆盖），并且与相对较低的放弃率相关，但由于每次放弃的检验都为机构节省了 1000 美元或更多，因此每年都实现了相当大的成本节约。
