Original scientific paper

https://doi.org/10.11613/BM.2018.030706

Computer physician order entry (CPOE) as a strategy to estimate laboratory activity and costs associated with cancer clinical trials

Enrique Rodriguez-Borja orcid.org/0000-0002-0339-6704 ; Laboratory of Biochemistry, Valencia University Clinic Hospital, Valencia, Spain
Africa Corchon-Peyrallo ; Laboratory of Biochemistry, Valencia University Clinic Hospital, Valencia, Spain
Macarena Diaz-Gimenez ; Laboratory of Biochemistry, Valencia University Clinic Hospital, Valencia, Spain
Arturo Carratala-Calvo ; Laboratory of Biochemistry, Valencia University Clinic Hospital, Valencia, Spain

Abstract

Introduction: Most of clinical laboratories are not properly reimbursed for their activity related to clinical trials (CTs) conducted in their institutions
due to a lack of measurement strategies. We implemented a specific computer physician order entry (CPOE) environment for CTs in order to facilitate
ordering to providers and estimate the associated costs to be compared with the standard of care (SOC).
Materials and methods: Four specific electronic formularies, restricted to two new virtual CTs clinical services (onco - CT and haemo - CT), were
implemented in January 2015. For each clinical trial displayed in the panels there were several box-cells that contained several profiles based on
the different phase of the trials. Tests included in the profiles were the tests required by protocol. Laboratory costs (€) per patient were compared
between the CTs services and their regular outpatients clinical services (onco - Out and haemo - Out, considered the SOC) for three years.
Results: Costs per patient were higher for CTs services and increased progressively each year (25%, 70% and 70% and 0.6%, 2.7% and 17% in 2015,
2016 and 2017 for Oncology and Haematology, respectively). Taking into account all these differences and the number of patients attending a total
difference in expense of + 130,377.7 € for the period 2015-2017 was obtained between CTs and outpatients services.
Conclusions: Strategies through CPOE systems based on restricted and specific profiles for CTs ordering are a promising tool that can improve laboratory
associated costs estimation and provide robust evidence in reimbursement negotiation processes with CTs sponsors.

Keywords

clinical decision support systems; computer physician order entry; health care costs; laboratory management; randomized controlled trials

Hrčak ID:

206658

URI

https://hrcak.srce.hr/206658

Publication date:

15.10.2018.

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