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How to employ technology that improves healthcare but increases costs has been much discussed. These authors note that Medicare spends $900 million annually on echocardiography and speculate that many orders for imaging are not appropriate. They have now briefly reported a single site's experience with an approach to improve test efficiency.
In 2006, the institution added a “limited” option of ordering transthoracic echocardiograms of only the left ventricle. The limited exam, which was estimated to cost one quarter that of the full exam, entailed five views of the left ventricle without Doppler imaging. Limited echocardiogram use grew from <1% of all echocardiograms in 2005 to about 20% by 2011. The number of total studies did not change si…