Introduction

This campaign provides information on Potentially Unnecessary Biochemical Testing one year after a series of interventions were conducted to reduce the number of tests performed without clinical indication.

• In August 2016, Eastern Health provided a new requisition form which omitted blood urea, LDH, and AST.
• In 2017, Quality of Care NL visited family doctors and discussed the need for ordering blood urea, LDH, creatine kinase, and ferritin.
• Monthly use of these five tests + Uric Acid from Jan 2015 – Dec 2017 by family doctors at Eastern Health is presented.

The Problem

The ordering of blood urea, LDH, creatine kinase, AST, uric acid, and ferritin may sometimes be unnecessary.

Our Data

Urea

The annual cost avoidance in Eastern Health resulting from the reduction in test usage is: $267,220

LDH

The annual cost avoidance in Eastern Health resulting from the reduction in test usage is: $37,136

Creatine Kinase

The annual cost avoidance in Eastern Health resulting from the reduction in test usage is: $44,264

AST

The annual cost avoidance in Eastern Health resulting from the reduction in test usage is: $31,028

Ferritin

The annual cost avoidance in Eastern Health resulting from the reduction in test usage is: $159,280

Uric Acid

Reduction in the use of uric acid, which was not removed from the requisition form and was not academically detailed, suggests a reduction in overall testing due to physician awareness of appropriate testing.

The annual cost avoidance in Eastern Health resulting from the reduction in test usage is: $24,716

Total Annual Cost Avoidance in Eastern Health from Unnecessary Biochemical Testing

Deletion of tests from the requisition form, as well as academic detailing appear to be associated with reduction in unnecessary use of biochemical tests.

What You Can Do

• Consider the appropriateness of the test BEFORE you order it.
• Review Practice Points Volume 3! Download the latest version of Practice Points here.
• Complete the Quality of Care NL CME modules! CFPC Online Learning Modules: www.med.mun.ca/qualityofcarenl