Version: 1.0.0 | Published: 15 May 2026 | Updated: 5 days ago
Documentation
Description:
Blood Testing in Inpatients – Computer-driven or Clinician Choice:
- To understand the proportion of blood tests, both clinician-ordered and system-ordered, which are collected successfully.
- To quantify the proportion of computer-driven blood orders that are manually rejected by clinicians.
- To estimate the expenditure on blood tests per patient between hospitals with and without automated ordering.
- To understand how levels of patient sickness and comorbidity influences blood-ordering behaviour.
Patients admitted to hospitals have high numbers of blood tests done during admissions. Electronic health records (EHRs), commonly utilise sophisticated clinical decision support systems (CDSS) that can, amongst other functions, propose new blood tests based on patient diagnoses, abnormal or changing test results, or other parameters such as observations, prescriptions, or planned procedures. This is perceived as improving safety as it helps ensure blood tests take place at critical timepoints in patient care and is widely employed in the version of PICS that is active on site.
However, as the complexity of any CDSS increases, so too does the likelihood that it will order unnecessary investigations. In this instance, this leads to unnecessary painful blood testing for patients, wastage of Trust resources with respect to equipment, laboratory capacity and staff time and contributes to problems associated with over-investigation such as iatrogenic anaemia, which itself may be associated with adverse patient outcomes.
In the same way that clinicians occasionally disagree over the value of a given investigation in a particular patient, no CDSS can avoid altogether the problem of ordering unnecessary investigations. However, based on anecdotal feedback both from patients and clinicians we hypothesise that there is scope to improve the existing system.
To assess this, we would like to use anonymised, individual-level patient and summary data to investigate the blood ordering behaviour of hospital departments in which computer-driven ordering is available and those in which it is entirely dependent on clinician input, to assess how both patient and system factors influence this behaviour, and to identify key areas where the CDSS may be refined to reduce unnecessary investigations whilst maintaining patient safety.
Coverage
Spatial:
West Midlands
Follow Up:
6 - 12 Months
Pathway:
Blood tests done during all kinds of admission type.
Provenance
Origin
Purposes:
Study
Sources:
Machine generated
Collection Situations:
- Secondary care - Accident and Emergency
- Secondary care - In-patients
- Secondary care - Outpatients
Temporal
Accrual Periodicity:
Static
Distribution Release Date:
13 May 2024
Start Date:
01 January 2023
End Date:
31 December 2023
Time Lag:
More than 6 months
Accessibility
Access
Access Rights:
Information Governance and Ethics - West Midlands Secure Data Environment (https://westmidlandssde.nhs.uk/information-governance-and-ethics)
Access Service:
Data Request Process - West Midlands Secure Data Environment
(https://westmidlandssde.nhs.uk/research/data-request)
Access Request Cost:
Please email wmsde@uhb.nhs.uk
Delivery Lead Time:
2-6 months
Jurisdictions:
GB
Data Controller:
University Hospitals Birmingham NHS Foundation Trust
Data Processor:
University Hospitals Birmingham NHS Foundation Trust
Usage
Data Use Limitations:
General research use
Data Use Requirements:
- Ethics approval required
- Project-specific restrictions
Resource Creators:
This publication uses data from the PATHWAY, an ethically approved Research Data Hub (NRES Reference 22/EE/0161)
Format and Standards
Vocabulary Encoding Schemes:
- ICD10
- NHS NATIONAL CODES
Conforms To:
LOCAL
Languages:
en
Formats:
SQL