Optimization of utilization of serum protein analysis

Role of the electronic medical record in promoting consultation by pathology

Hamid M. Zia, Gurmukh Singh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Screening for monoclonal gammopathies is usually done by serum protein electrophoresis (SPEP) and serum free light chain tests. SPEP may be followed by immunofixation electrophoresis (IFE). IFE may be ordered by the treating physician or be at the discretion of the pathologist. We examined the appropriateness of IFE ordering by treating physicians and report on our findings, follow-up changes to the ordering process, and results of the change. We retrospectively analyzed the data from our laboratory from April 2009 through July 2012. In April 2009, 3 options for test ordering were available for the clinicians: SPEP with reflex IFE, SPEP only, and SPEP with IFE. This test ordering option was limited to SPEP with reflex IFE only in April 2010. We compared the rates of SPEP and IFE performed in the 2 periods (ie, April 2009 through April 2010 and May 2010 through July 2012). There was a substantial drop in the IFE/SPEP ratio from 0.47 to 0.21. Review of electronic medical records by the consultant pathologist was instrumental in improving the utilization and enhancing the value of pathology consultation. Possible impacts on laboratory costs, revenue, and overall health care are also presented.

Original languageEnglish (US)
Pages (from-to)793-797
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume139
Issue number6
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

Fingerprint

Electronic Health Records
Electrophoresis
Blood Proteins
Referral and Consultation
Pathology
Reflex
Physicians
Paraproteinemias
Consultants

Keywords

  • Electronic medical records
  • Laboratory utilization
  • Monoclonal gammopathies
  • Serum free light chain assays
  • Serum immunofixation electrophoresis
  • Serum protein electrophoresis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

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abstract = "Screening for monoclonal gammopathies is usually done by serum protein electrophoresis (SPEP) and serum free light chain tests. SPEP may be followed by immunofixation electrophoresis (IFE). IFE may be ordered by the treating physician or be at the discretion of the pathologist. We examined the appropriateness of IFE ordering by treating physicians and report on our findings, follow-up changes to the ordering process, and results of the change. We retrospectively analyzed the data from our laboratory from April 2009 through July 2012. In April 2009, 3 options for test ordering were available for the clinicians: SPEP with reflex IFE, SPEP only, and SPEP with IFE. This test ordering option was limited to SPEP with reflex IFE only in April 2010. We compared the rates of SPEP and IFE performed in the 2 periods (ie, April 2009 through April 2010 and May 2010 through July 2012). There was a substantial drop in the IFE/SPEP ratio from 0.47 to 0.21. Review of electronic medical records by the consultant pathologist was instrumental in improving the utilization and enhancing the value of pathology consultation. Possible impacts on laboratory costs, revenue, and overall health care are also presented.",
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