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Centre for Health Systems and Safety Research

Centre for Health Systems and Safety Research. Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction. E Vecellio 1 , A Georgiou 1 , G Toouli 1 , A Eigenstetter 2 , L Li 1 , R Wilson 2 , JI Westbrook 1.

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Centre for Health Systems and Safety Research

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  1. Centre for Health Systems and Safety Research Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction E Vecellio1, A Georgiou 1, G Toouli 1, A Eigenstetter2, L Li 1, R Wilson 2, JI Westbrook 1 1 Centre for HealthSystems and Safety Research, University of New South Wales, Sydney, NSW 2 South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW

  2. Research Areas

  3. Background Too many tests? Too few tests? The ‘just right’ number of tests?

  4. Background Overall Test Volume Test Order Rate Per Patient Day

  5. Background 20-25% DRG Length of stay Ancillary service utilisation Nursing hours DRG as a grouping variable Kuczynski et al. (1997) Vascular surgeons' resource use at a university hospital related to diagnostic-related group and source of admission. J VascSurg

  6. Research Questions DRG Test Order Rate Per DRG Per Patient (Per Day)

  7. Research Questions Monitor test volume during the implementation of EMR

  8. Research Questions Compare Six Hospitals

  9. Setting and Methods EMR incorporated Cerner PowerChart CPOE system. (Initially, version 2007 then, during 2011, version 2010.) The EMR was implemented at the six hospitals gradually between Oct 2008 and Oct 2009. Our dataset included two-months of data (Aug-Sep) for each of four years (2008-2011). 2011: EMR used for ~66% of pathology orders

  10. Data Linkage Image: FreeDigitalPhotos.net renjithkrishnan

  11. Data Linkage Pathology tests: 1,256,079 Inpatient admissions: 71,191 Image: FreeDigitalPhotos.net renjithkrishnan

  12. Results Mean Number of Tests per Inpatient EMR@3 EMR@6 Hospitals

  13. EMR@3 EMR@6 Hospitals Results Mean Number of Tests per Inpatient

  14. Research Questions Image: FreeDigitalPhotos.net / nokhoog_buchachon DRG: Chest Pain (F74Z) Compare Four EDs

  15. Data Linkage DRG: Chest Pain (F74Z) Image: FreeDigitalPhotos.net / nokhoog_buchachon Pathology tests: 6,803 ED presentations: 988 Image: FreeDigitalPhotos.net renjithkrishnan

  16. Results DRG: Chest Pain (F74Z) Image: FreeDigitalPhotos.net / nokhoog_buchachon Mean Rate of Tests per ED Presentation Hospital ED Rank 5 3 3 3 3 2 4 3 3 3 4 4 4 4 4 4 5 1 5 4 5 6 5 7 6 1 2 1 2 1 2 1 2 1 2 1 1 2 2 2 2008 2011

  17. So, what does it mean?

  18. Thank You This project was funded by a grant from: Australian Government Department of Health and Ageing, Quality Use of Pathology Program. Email: e.vecellio@unsw.edu.au www.aihi.unsw.edu.au

  19. Centre for Health Systems and Safety Research Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction E Vecellio1, A Georgiou 1, G Toouli 1, A Eigenstetter2, L Li 1, R Wilson 2, JI Westbrook 1 1 Centre for HealthSystems and Safety Research, University of New South Wales, Sydney, NSW 2 South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW

  20. EMR@3 EMR@6 Hospitals Results Mean Number of Tests per Inpatient per Day

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