The role of a best practice alert in the electronic medical record in reducing repetitive lab tests

The recommendations of the American Board of Internal Medicine Foundation's "Choosing Wisely " initiative recognize the importance of improving the appropriateness of testing behavior and reducing the number of duplicate laboratory tests. To assess the effectiveness of an electronic medical record Best Practice Alert (BPA or "pop up") intervention aimed at reducing duplicate laboratory tests and hospital costs. Comparison of the number of duplicated laboratory tests performed on inpatients before and after the intervention. University of Florida Health Shands Hospital, Gainesville, FL, USA, during 2014-2017. The electronic medical record intervention was a BPA pop-up alert that informed the ordering physician if a recent identical order already existed along with the "ordering time", "collecting time", "resulting time", and the result itself. Percentage change in the number of inpatient duplicate orders of selected clinical biochemistry tests and cost savings from reduction of the duplicates. Student's -test and beta-binomial models were used to analyze the data. Results from the beta-binomial model indicated that the intervention reduced the overall duplicates by 18% (OR=0.82, standard error=0.016, -value