RT Journal Article SR Electronic T1 Inappropriate Testing for Acute Viral Hepatitis Is Common—Impact of an Intervention Using the Electronic Health Record in a Tertiary Teaching Hospital in the United States JF Ochsner Journal JO Ochsner J FD O. P. Jindal Global University SP 293 OP 298 DO 10.31486/toj.19.0062 VO 20 IS 3 A1 Muhammad Bader Hammami A1 Kamran Hussaini A1 Anuj Chhaparia A1 Hamza Khalid A1 Robin Chamberland A1 Brent Neuschwander-Tetri YR 2020 UL http://www.ochsnerjournal.org/content/20/3/293.abstract AB Background: Unnecessary laboratory tests contribute to the financial burden placed on hospitals, patients, insurers, and taxpayers. In our institution, we noted acute viral hepatitis serologic testing in patients with chronic liver disease, sometimes done repetitively, in the absence of substantially elevated aminotransferase levels. The goal of this study was to determine the frequency of unnecessary testing for acute hepatitis A and B infections and then reduce testing rates by implementing an intervention in the electronic health record.Methods: In a 2-year period, 2 successive interventions questioning the appropriateness of ordering viral hepatitis serology based on transaminase elevation and prior serology results were implemented in the electronic health record system at Saint Louis University Hospital. The first intervention allowed providers to override the warning without providing a reason; the second intervention required justification to proceed with the order. Preintervention and postintervention appropriate and inappropriate testing proportions were compared using Fisher exact test.Results: The electronic reminders resulted in a statistically significant reduction of inappropriate testing rates; however, testing rates remained high whether the provider had to justify overriding the automatic alert or not.Conclusion: Our research demonstrated that the rates of inappropriate testing for acute viral hepatitis at our institution were unnecessarily high and showed that a simple intervention in the medical record system may be useful in reducing inappropriate testing. Our interventions were feasible and implemented at minimal cost. Similar interventions could be used to target other unnecessary tests, but education and additional interventions will likely be required to reduce unnecessary testing further.