Less Is More When Battling Bronchiolitis Using Epic

Using customized ordering workflows in Epic and real-time reporting dashboards focused on reducing ineffective testing and treatments for bronchiolitis, Children’s Hospital Colorado saw up to 40% decreases in the rates targeted procedures were ordered.

Clinicians have traditionally used tests such as chest x-rays, viral panels, and treatments like bronchodilators to combat bronchiolitis, but these procedures can be troublesome for infant patients. In some cases, they can lead to a misdiagnosis of a more serious condition: for example, bronchiolitis often appears similar to bacterial pneumonia in chest x-rays, leading to unnecessary antibiotic use.

CHC established a team focused specifically on reducing tests and treatments that increase costs and lengths of stay for infant bronchiolitis patients. In Epic, the team streamlined and updated their order sets and created care pathways that recommended less invasive tests and treatments for non-severe cases. A dashboard also drew real-time data from clinicians’ test-ordering habits in the system.

Their initiative resulted in a 40% decrease in chest x-rays, a 22% decrease in viral tests, and a 41% decrease in the use of bronchodilators, all without seeing any setbacks in rates of ICU transfers or readmissions.

For their efforts in reducing unnecessary tests and treatments for bronchiolitis and a similar initiative for appendicitis diagnoses, CHC was one of several organizations using Epic to receive a 2018 HIMSS Davies Enterprise Award. Epic community members can learn more about CHC’s program on the UserWeb.