There are some lab tests, like Hemoglobin Electophoresis, that never change. Yet they are often ordered multiple times of the same patient. For example, we order one every pregnancy even though you are not going to acquire sickle cell trait between two pregnancies. Another example is screening for genetic carriers, like CF. That has been ordered more than once on the same patient. Perhaps the lab could simply indicate that the lab was not done because a result already exists and to resubmit if you really want to run the test.

Also, patient get referred for ultrasounds at UCSF for follow up on genetic screening.  They often have pre-existing sono appointments at SFGH. These appointments often happen during the interval between prenatal visits and is not caught by the primary OB provider until the patient has already had an unnecessary scan. If there would be  away to see if a patient had a recent scan at UCSF before repeating the exact same study at SFGH that would save the cost associated with the redundant SFGH scan.