Don’t support ordering system mechanisms that contribute to over-testing. Encourage the development of an evidence-based utilization management program that may include interventions such as unbundling order sets, reflex testing algorithms, and decision-support technology.

Over-testing is a recognized problem, and evidence supports multi-faceted interventions that capitalize on advances in computer-based ordering technology. Bundling of tests may provide results that are not necessary for the ordering professional and may lead to duplication of testing or unnecessary follow-up. Order sets should be regularly reviewed. Research supports increased collaboration of all healthcare providers, including laboratory personnel, in combating over-testing. Laboratory professionals can be involved at all stages of interventions from problem recognition, feedback provision, to participation in the creation of supportive education materials and ordering guidelines.
For more information:

Ferraro S, Panteghini M. The role of the laboratory in ensuring appropriate test requests. Clin Bioch 2017;50(10-11):555-61. PMID: 28284827.

Jackups R, Szymanski J, Persaud S. Clinical decision support for hematology laboratory test utilization. Int J Lab Hem 2017;39:128-35. PMID: 28447421.

Krasowski M, Chudzik D, Dolezal A, Steussy B, Gailey M, Koch B, et al. Promoting improved utilization of laboratory testing through changes in an electronic medical record: Experience at an academic medical center. BMC Med Inform Decision 2015;15(1):11. PMID: 25880934.

Rubinstein M, Hirsch R, Cornish N. Effectiveness of practises to support appropriate laboratory test utilization. A laboratory medicine best practises systematic review and meta-analysis. Am J Clin Path 2018;149(30):197-221. PMID: 29471324.

Nazerian P, Vannit S, Fanelli A, Fallai L, Duranti C, Ognibene A, et al. Appropriate use of laboratory test requests in the emergency department: a multilevel intervention. Eur J Emerg Med 2019;26(3):205-11. PMID: 29176456.