1. Expert opinions are used to modify the redundancy “cut off” windows
Reducing Lab Costs: A Novel Opportunity Nila Radhakrishnan MD1; Nikhil Agrawal MD1; Rohit Bishnoi MD1; Ahmad Ahmad1; Neil Harris MD, MB, ChB2 ; Stacy Beal MD2; Kenneth Rand MD2; Robert Leverence MD1 1Division of Hospital Medicine, Department of Medicine 2Department of Pathology, Immunology, and Laboratory Medicine University of Florida College of Medicine, Gainesville, FL
Methods
Background
Duplicate lab testing is often unnecessary and adds burden to the health care system
Redundant testing can lead to increased cost, unnecessary phlebotomy, decreased patient satisfaction, and iatrogenic anemia
17 tests and redundancy windows are short listed by a team of Internists and Pathologists
Expert opinions are used to modify the redundancy “cut off” windows
Retrospective data collected from a range of two weeks to six months. An IRB waiver was obtained.
Duplicate testing was manually counted for each individual test and that information was extrapolated to the year
Costs per test were provided by the lab and used to estimate the annual cost of this redundancy.
Objective
Form a multidisciplinary team to look at reducing lab tests costs
Identify the most common inpatient tests
Develop consensus on a time frame defining a lab test s duplicate or redundant
Collect data on incidence of duplicate lab testing
Estimate annual cost of this redundancy $ ,
Conclusion
Duplicate laboratory tests represent a large cost and an opportunity for savings. 
Often, tests are duplicated because physicians did not know about tests that were previously ordered or resulted. 
The electronic medical record and computerized physician order entry allow us an opportunity to decrease duplicate laboratory testing.
In the next phase of this project, we plan to implement a clinical decision support tool to alert physicians when a duplicate test is being ordered 
We hope this will decrease the number of duplicate tests ordered and result in a cost savings.  This may also reduce unnecessary phlebotomy which may also improve patient satisfaction.