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Optimal Utilization of Laboratory Testing


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Changes to Manual Requisitions2,7

Slide 5

November 2011

Here's some changes to manual requisitions for those of you who may use paper orders. We need to send the obsolete tests into the sunset and this is a picture of me riding my horse in Arizona into the sunset with some obsolete tests—single stranded DNA, bleeding time, and T3 uptake. If you have paper requisitions, you need to be supported by a policy and procedure to destroy your old requisitions. I would recommend a hunt for those requisitions to get those out of the doctor's offices so that only your most current requisition is available. Many of us are on electronic orders at this time. Regardless of whether you’re on paper or electronic, we need to eliminate esoteric tests. For example, neurogenetic testing from requisitions used in primary care. Just recently, in my own practice, someone inadvertently ordered a second order of pancreatic polypeptide. The doctor had not intended to order that but the second order showed that the pancreatic polypeptide was increased 2 times normal. Now this isn’t a very good test for screening for neuroendocrine pancreatic tumors and it took some time to unravel what this actually meant. Which probably didn't mean anything since the prevalence of the disease in this particular population of patients wasn’t very high. Now, on the other side, check test requested, you can see that these are some esoteric tests. And some academic medical centers have actually gone as far as prohibiting everyone on staff being able to identify and order every single test.

Changes to Manual Requisitions2,7


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