Question 1

What is meant by a "dual finding" in the preoperative process?

Accepted Answer

A duplicate test occurs when a diagnostic test—such as a lab test, X-ray, or ECG—is performed again even though a conclusive result addressing the same issue is already available. In most cases, this is not due to medical necessity, but rather because the previous findings were not available at a handoff point between the doctor’s office, the outpatient clinic, and the hospital ward.

Question 2

Why do duplicate tests occur despite existing prior findings?

Accepted Answer

Because medical history and examination findings are often transferred incompletely when responsibility is transferred—for example, on paper, in incompatible systems, or simply too late. The treating physician then re-examines the patient out of a duty of care because reliable information is missing, not out of carelessness.

Question 3

What do the current guidelines on preoperative diagnostics say about routine examinations?

Accepted Answer

The joint recommendation from the DGAI, DGCH, and DGIM, updated in 2024, explicitly rejects routine laboratory screening. Further testing is indicated only if a complete medical history and physical examination provide concrete evidence that actually influences the perioperative management.

Question 4

How does a structured digital medical history help prevent duplicate findings?

Accepted Answer

It records pre-existing conditions and medications in a structured format rather than as free text, continuously checks the information for completeness, and makes it available at every handoff point via HIS interfaces. This ensures that the complete medical history—which, according to the guidelines, is a prerequisite for being able to forgo additional diagnostic tests—is available.

Question 5

Does Medical Reasoning replace the physician's judgment when evaluating previous findings?

Accepted Answer

No. Medical Reasoning identifies gaps and anomalies in the medical history data and asks targeted follow-up questions, but it does not make any medical decisions. The decision as to whether a previous examination is sufficient or whether a new examination is necessary rests solely with the physician.

Question 6

Are there reliable figures on the costs of duplicate test results in Germany?

Accepted Answer

There is currently no publicly available, standalone figure specifically for duplicate test results—health insurance companies do not track them as a separate category. However, the scale of the underlying inefficiency can be estimated based on studies of the potential for digital cost savings in the healthcare sector as a whole (approximately 34 billion euros annually in Germany, McKinsey 2018).

Duplicate Findings

Avoiding Duplicate Findings Through a Structured Medical History—A Cost Factor for Hospitals and Health Insurers

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