Identifying and Removing Duplicate Test Requests

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When a healthcare professional orders blood tests, it is usually with the intent to exclude or confirm certain diagnoses, or to reassure themselves and the patient that there is nothing wrong.However, across NHS primary care and secondary care -- for both inpatients and outpatients, duplicate blood test requests are generated and carried out. The source of duplications is manifold, including system errors of unknown origin, multiple healthcare providers interacting with the same patient and emergency care protocols.For example, patients may see several different doctors within the same hospital, each who orders blood tests, each potentially unaware of what the others have ordered. Yet all of these results go back to the same system source of request - be it a GP surgery or hospital. Additionally, there are patients who require recurring blood testing who may miss an appointment for blood tests, and then attend three months later for their next scheduled test, at which point both the one-month and three-month blood tests are taken at the same time in response to the live requests on the system. Salutare estimates that 5% of all blood tests are duplicates of these types (the same blood test being taken on the same patient, on the same date and time), and there is never a clinical reason to duplicate test requests, providing all clinicians involved in the patient's care are notified with access to the results.If we can accurately identify and remove these unnecessary duplicate requests the impact is considerable; pathology staff time processing duplicate requests, patient time and resource saved, fewer testing consumables used -- overall significant savings across the NHS when scaled. Based on preliminary data from the Royal Free London Hospital, we estimate that removing the ~5% duplicate test requests could save the hospital up to £2M per year. Salutare proposes to capture, understand and remove system duplicates to address the negative impact that this has on NHS resource and patient experiences.