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Tracking Resident Orders to See If They’re Reducing Unnecessary Tests

Tracking Resident Orders to See If They’re Reducing Unnecessary Tests

Does showing residents the number of hospital tests they order in comparison to their peers encourage them to order more appropriately?

Physicians in the Department of Medicine will find out, thanks to a soon-to-be-launched dashboard that uses Epic data to track the number of tests residents order for patients. The dashboard focuses on residents because they manage most hospitalized Department of Medicine patients, but it could one day be broadened to include faculty members.

“There’s no way to change behavior if you don’t know what your behavior is,” says Lenny Feldman, an internist who helped create the dashboard with fellow internist Amit Pahwa and the Johns Hopkins Technology Innovation Center.

The Buffy Care dashboard (named after Buffy the Vampire Slayer) focuses on tracking blood tests and imaging, like CT and MRI scans. Residents can compare their test-ordering behavior to those of their anonymous peers. The dashboard is part of a growing interest around the country for hospitals to provide high-value health care—delivering the best outcomes at the lowest cost. Feldman and Pahwa are both directors on the Johns Hopkins Department of Medicine High Value Care Committee.

For now, the dashboard does not include information on cost or whether residents correctly ordered. Select chief residents will have access to the data for feedback purposes.

Feldman and Pahwa acknowledge that residents’ ordering patterns may be affected by the nature and degree of their patients’ illnesses. Nevertheless, they hope that by making residents aware of their practices, they’ll be more inclined to ensure the tests they order are necessary for patients’ care.

The team used U.S. Health Resources and Services Administration funding to contract the Technology Innovation Center to build the dashboard. Pahwa says the final hurdle is making sure data are accurate before the dashboard’s launch in 2017.

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