Design of a decision support system for test ordering in general practice:Choices and decisions to make

The increased availability of tests in the past years has been accompanied by an increased number of blood tests ordered by general practitioners. Dut ch investigators: report a lack of general practitioners' knowledge concern ing the indications for blood tests leading to inappropriate and inadequate use of diagnostic tests. Taking advantage of the use of electronic patient records by Dutch general practitioners, the authors replaced the tradition al paper forms for test ordering by a decision-support system, The objectiv e of the decision-support system is to change test-ordering behavior. Desig ning a system to change test-ordering behavior, however, required the selec tion of a method to provide support. To study different methods for changin g test-ordering behavior, the authors developed two versions of the decisio n-support system BloodLink. The first version, BloodLink-Restricted, is bas ed on the notion of restricting the number of choices presented to the gene ral practitioners. The second version, BloodLink-Guideline, is based on the guidelines provided by the Dutch college of general practitioners.