Does your institution have formal policies or work flows to reduce unnecessary IGRAs ordered for patients on biologics?   

We have developed a multi-specialty working group to implement this as a lot of unnecessary testing is getting done. This will include having a 2-3 question screening pre start of biologics, and then annually to asses risk, that we hope will be incorporated into the visit or an order set.

I find this question interesting for a couple of reasons. One, it is about cost reduction, a topic I am certainly not against. Two, and more intriguingly, it assumes we ID docs are now all part of an institution. My father, known to many of you, warned me about institutions.