Preventing Genetic Testing Order Errors With a Laboratory Utilization Management Program.

Abstract:

OBJECTIVES:To characterize error rates for genetic test orders between medical specialties and in different settings by examining detailed order information. METHODS:We performed a retrospective analysis of a detailed utilization management case database, comprising 2.5 years of data and almost 1,400 genetic test orders. After review by multiple reviewers, we categorized order modifications and cancellations, quantified rates of positive results and order errors, and compared genetics with nongenetics providers and inpatient with outpatient orders. RESULTS:High cost or problems with preauthorization were the most common reasons for modification and cancellation, respectively. The cancellation rate for nongenetics providers was three times the rate for geneticists, but abnormal result rates were similar between the two groups. The approval rate for inpatient orders was not significantly lower than outpatient orders, and abnormal result rates were similar for these two groups as well. Order error rates were approximately 8% among tests recommended by genetics providers in the inpatient setting, and tests ordered or recommended by nongeneticists had error rates near 5% in both inpatient and outpatient settings. CONCLUSIONS:Clinicians without specialty training in genetics make genetic test order errors at a significantly higher rate than geneticists. A laboratory utilization management program prevents these order errors from becoming diagnostic errors and reaching the patient.

journal_name

Am J Clin Pathol

authors

Mathias PC,Conta JH,Konnick EQ,Sternen DL,Stasi SM,Cole BL,Astion ML,Dickerson JA

doi

10.1093/ajcp/aqw105

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

221-6

issue

2

eissn

0002-9173

issn

1943-7722

pii

aqw105

journal_volume

146

pub_type

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