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The introduction of a diagnostic decision support system (DXplain™) into the workflow of a teaching hospital service can decrease the cost of service for diagnostically challenging Diagnostic Related Groups (DRGs).

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Title: The introduction of a diagnostic decision support system (DXplain™) into the workflow of a teaching hospital service can decrease the cost of service for diagnostically challenging Diagnostic Related Groups (DRGs).
Authors: Elkin PL (AUTHOR), Liebow M (AUTHOR), Bauer BA (AUTHOR), Chaliki S (AUTHOR), Wahner-Roedler D (AUTHOR), Bundrick J (AUTHOR), Lee M (AUTHOR), Brown SH (AUTHOR), Froehling D (AUTHOR), Bailey K (AUTHOR), Famiglietti K (AUTHOR), Kim R (AUTHOR), Hoffer E (AUTHOR), Feldman M (AUTHOR), Barnett GO (AUTHOR), Elkin, Peter L1 (AUTHOR), Liebow, Mark (AUTHOR), Bauer, Brent A (AUTHOR), Chaliki, Swarna (AUTHOR), Wahner-Roedler, Dietlind (AUTHOR)
Source: International Journal of Medical Informatics. Nov2010, Vol. 79 Issue 11, p772-777. 6p.
Abstract: Background: In an era of short inpatient stays, residents may overlook relevant elements of the differential diagnosis as they try to evaluate and treat patients. However, if a resident's first principal diagnosis is wrong, the patient's appropriate evaluation and treatment may take longer, cost more, and lead to worse outcomes. A diagnostic decision support system may lead to the generation of a broader differential diagnosis that more often includes the correct diagnosis, permitting a shorter, more effective, and less costly hospital stay.Methods: We provided residents on General Medicine services access to DXplain, an established computer-based diagnostic decision support system, for 6 months. We compared charges and cost of service for diagnostically challenging cases seen during the fourth through sixth month of access to DXplain (intervention period) to control cases seen in the 6 months before the system was made available.Results: 564 cases were identified as diagnostically challenging by our criteria during the intervention period along with 1173 cases during the control period. Total charges were $1281 lower (p=.006), Medicare Part A charges $1032 lower (p=0.006) and cost of service $990 lower (p=0.001) per admission in the intervention cases than in control cases.Conclusions: Using DXplain on all diagnostically challenging cases might save our medical center over $2,000,000 a year on the General Medicine Services alone. Using clinical diagnostic decision support systems may improve quality and decrease cost substantially at teaching hospitals. [ABSTRACT FROM AUTHOR]
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Abstract:<bold>Background: </bold>In an era of short inpatient stays, residents may overlook relevant elements of the differential diagnosis as they try to evaluate and treat patients. However, if a resident's first principal diagnosis is wrong, the patient's appropriate evaluation and treatment may take longer, cost more, and lead to worse outcomes. A diagnostic decision support system may lead to the generation of a broader differential diagnosis that more often includes the correct diagnosis, permitting a shorter, more effective, and less costly hospital stay.<bold>Methods: </bold>We provided residents on General Medicine services access to DXplain, an established computer-based diagnostic decision support system, for 6 months. We compared charges and cost of service for diagnostically challenging cases seen during the fourth through sixth month of access to DXplain (intervention period) to control cases seen in the 6 months before the system was made available.<bold>Results: </bold>564 cases were identified as diagnostically challenging by our criteria during the intervention period along with 1173 cases during the control period. Total charges were $1281 lower (p=.006), Medicare Part A charges $1032 lower (p=0.006) and cost of service $990 lower (p=0.001) per admission in the intervention cases than in control cases.<bold>Conclusions: </bold>Using DXplain on all diagnostically challenging cases might save our medical center over $2,000,000 a year on the General Medicine Services alone. Using clinical diagnostic decision support systems may improve quality and decrease cost substantially at teaching hospitals. [ABSTRACT FROM AUTHOR]
ISSN:13865056
DOI:10.1016/j.ijmedinf.2010.09.004