Low-value medical orders: bridging the gap between concept and action in reducing healthcare waste

Healthcare systems worldwide face the dual challenge of improving quality while controlling costs. Value-based healthcare has emerged as a guiding framework, yet a substantial proportion of delivered services remain low-value, providing minimal benefit while consuming resources and potentially causing harm. While low-value care has been extensively studied at the service level, less attention has been paid to the fundamental unit that initiates all healthcare delivery: the medical order. This commentary introduces the concept of low-value medical orders (LVMO) as a complementary framework to existing low-value care paradigms. By focusing on the point of clinical decision-making, LVMO offers a more actionable target for real-time intervention. We distinguish LVMO from low-value care across multiple dimensions and discuss how this framework can inform multilevel strategies combining clinician-focused interventions with broader system reforms. Drawing on recent systematic reviews of de-implementation interventions, we identify critical research gaps and propose directions for developing effective, sustainable approaches to reduce unnecessary ordering.