Identifying and Removing Duplicate Test Requests

当医疗保健专业人员要求进行血液检查时，通常是为了排除或确认某些诊断，或者让自己和病人放心，没有任何问题。然而，在NHS的初级保健和二级保健中，无论是住院病人还是门诊病人，都会产生和执行重复的血液检测请求。重复的来源是多方面的，包括未知来源的系统错误，多个医疗保健提供者与同一患者互动以及紧急护理协议。例如，患者可能会在同一家医院看到几个不同的医生，每个医生都要求进行血液检查，每个人都可能不知道其他人的要求。然而，所有这些结果都返回到同一个系统请求来源——无论是全科医生手术还是医院。此外，有些需要反复验血的患者可能会错过验血的预约，然后在三个月后参加下一次安排的验血，此时同时进行一个月和三个月的验血，以响应系统上的实时请求。Salutare估计，所有血液检查中有5%是这些类型的重复（在同一日期和时间对同一患者进行相同的血液检查），并且只要所有参与患者护理的临床医生都能获得结果，就没有临床理由重复检测请求。如果我们能够准确地识别和删除这些不必要的重复请求，影响是相当大的；病理工作人员处理重复请求的时间，节省了患者的时间和资源，减少了测试耗材的使用，在整个NHS规模上节省了大量资金。根据伦敦皇家自由医院的初步数据，我们估计，消除约5%的重复检测请求，每年可为医院节省高达200万英镑。Salutare建议捕获、理解和删除系统重复，以解决这对NHS资源和患者体验的负面影响。

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.