Table 5 Most common issues detected by and subsequently corrected following pathology review of draft EMR order sets

Erroneous inclusion of test that had similar name to intended test

• Lactate dehydrogenase (LDH) isoforms instead of LDH

• Amylase isoforms instead of amylase

• Confusion of beta-2-microglobulin and beta-2-glycoprotein

Confirmatory/specific test used instead of common screening test

• Hepatitis B DNA instead of hepatitis B surface antigen

• Hepatitis C RNA instead of hepatitis C antibody

• HIV viral load instead of HIV antigen/antibody combo assay

Repetitive ordering of common tests, either too frequent time intervals or for too long duration or both

• Basic metabolic panel (sodium, potassium, carbon dioxide, chloride, calcium, blood urea nitrogen, creatinine, glucose)

• Complete blood count (with or without differential)

• Blood gases

• Lactate

• Liver enzymes (e.g., alanine aminotransferase, aspartate aminotransferase)

• Osmolality

Selection of obsolete testing or low yield testing

• Chlamydia culture instead of Chlamydia PCR

• Antibody assays for fungi endemic to Iowa (e.g., Histoplasma, Blastomyces) instead of higher yield antigen or culture-based tests