# Leveraging the electronic health records to mitigate the effects of a nation-wide shortage of blood culture bottles

## TL;DR

A health system used electronic health records and data tools to cut blood culture bottle use by 81% during a shortage, without harming patient care.

## Contribution

Demonstrates how EHR optimization and clinical decision support can effectively manage critical resource shortages in healthcare.

## Key findings

- An 81% sustained reduction in daily blood culture utilization was achieved during the shortage.
- Blood culture positivity and contamination rates remained stable before and after interventions.
- Alerts led to 16% of orders being canceled, with only 3% reordered within an hour.

## Abstract

To evaluate how electronic health records (EHR) optimization and data analytics supported a large rural health system action plan to mitigate the effects of a nation-wide blood culture bottle shortage.

Following the announcement of a nationwide blood culture bottle shortage on July 10, 2024, we implemented EHR order modification, alternative alerts (LMAs) for clinical decision support (CDS), and developed a data analytics dashboard to track daily orders and inventory. We analyzed changes in daily blood culture specimen utilization before and after the EHR interventions using run charts. We assessed blood culture positivity and contamination rates, and provider interactions with LMAs as process measures.

The EHR-based interventions led to a sustained 81% reduction in daily blood culture utilization during the shortage. Blood culture contamination rates remained consistent at 5.1% pre- and post-interventions, and positivity rates were stable (13.5% pre vs 12.8% post). Analysis of LMAs showed that 16% of blood culture orders were canceled after the alert, with only 3% reordered within one hour. The utilization and inventory monitoring reports became top 10% most-used within the health system, supporting operational decisions.

Combining EHR optimization, CDS via LMAs, and data analytics effectively mitigated a critical resource shortage, demonstrated by a sustained 81% reduction in blood culture bottle utilization without compromising patient care. EHR order modifications contributed to the initial reduction; LMAs sustained the decrease and were well-received compared to traditional alerts. Rapid development of data analytics reports supported data-driven operational decisions.