Many Vitamin D test orders can be considered unnecessary and low-value care. MPrOVE evaluated an EHR intervention to alert clinicians of probable low-value Vitamin D orders. This resulted in a significant decrease of Vitamin D test orders over a period of time, which in turn, saves time, resources, and creates healthcare savings.

Background: A majority of vitamin D testing can be ruled as unnecessary or low-value due to limited evidence of population-based screening improving outcomes for patients without specified high-risk conditions, as noted by the American Society for Clinical Pathology’s Choosing Wisely campaign.

To identify goals of a proposed intervention, MPrOVE worked with the Lab Stewardship Committee to identify specific lab tests with the most opportunity for reducing low-value utilization. In addition, MPrOVE developed a framework for measuring low-value laboratory testing. Once vitamin D testing was selected, MPrOVE evaluated changes in testing rates at Michigan Medicine resulting from a quality improvement intervention to decrease the use of unnecessary vitamin D testing among adult primary care patients.

MPrOVE Role: MPrOVE evaluated vitamin D testing rates at Michigan Medicine and implemented a Quality Improvement electronic health record (EHR) intervention to decrease the use of unnecessary vitamin D testing among adult primary care patients. Vitamin D ordering during three distinct time periods were measured:

Outcomes: The implementation of an EHR decision alert contributed to decreasing rates of low-value Vitamin D testing, which contributes to saving staff resources and time, and creates healthcare savings.

Additional Information:

• Reducing Unnecessary Vitamin D Screening in an Academic Health System: What Works and When