ASH Choosing Wisely® Champions - Ravindra Sarode, MD

Ravindra Sarode, MD, of UT Southwestern Medical Center, was selected as one of the three inaugural ASH Choosing Wisely Champions for his project, "Reduction in Unnecessary or Misapplied Thrombophilia Testing in Patients with DVT, PE, or Other Thrombotic Disorders Using Combination of Education and EMR Alerts."

Dr. Sarode and his colleagues discovered that approximately 85 percent of thrombophilia tests at UT Southwestern’s two teaching hospitals were ordered incorrectly or incompletely. Thrombophilia tests are frequently ordered (usually by non-hematologists) for patients with acute thrombotic events, often while the patient is on anticoagulation therapy; however, sometimes additional variables can cause these standard tests to return false positive results. These abnormal results are not always checked for reproducibility or accuracy, causing some patients to be inappropriately placed on long-term anticoagulation therapy. To promote appropriate use of testing, Dr. Sarode’s team developed local guidelines and implemented them in the electronic medical record via a series of cascading questions that providers must answer before ordering tests. After implementation of the intervention and an associated education campaign, UT Southwestern has reduced thrombophilia testing for inpatients in the university hospital by more than 90 percent.