Il “software” GOELM come innovativa modalità di gestione della conoscenza e della prescrizione degli esami di laboratorio: l’esperienza di due Unità Sociosanitarie Locali

Laboratory tests play a pivotal role in the diagnostic process. Unfortunately, their usefulness is undermined by a substantial proportion of inappropriateness. Up to now the employed strategies appear inadequate to solve the problem. This study presents a structural solution based on health information technology. In 2008 and 2010, an innovative way for prescribing laboratory tests was tested with the help of general practitioners of ULSS 18 Rovigo and ULSS 13 Mirano. It uses a software called GOELM (Guide Order Entry Laboratory Medicine). During the order entry, the software proposes indications about the clinical use of the laboratory test in real time. The general practitioner could accept or not the indication. The number of prescriptions formulated with the use of GOELM was compared with the number of prescriptions formulated by the same doctors without GOELM in the same period of the previous year. Our results demonstrate that the use of GOELM software has achieved a reduction in the total number of prescriptions up to 38% in Rovigo and up to 26% in Mirano. This trial demonstrates that it is possible to make governance in prescription without political and/or administrative measures. GOELM was therefore proved effective in reducing the inappropriateness through knowledge managemen