Clinical-decision support systems may control use of imaging

Investigators from Virginia Mason Medical Center in Seattle found that clinical-decision support systems can help reduce inappropriate medical imaging, such as unnecessary CT and MRI scans.

C. Craig Blackmore

“Clinical-decision support systems are point-of-order decision aids, usually through computer order entry systems, that provide real-time feedback to providers ordering imaging tests, including information on test appropriateness for specific indications,” C. Craig Blackmore, MD, MPH, lead author of the study, stated in a press release from the American College of Radiology.

The retrospective cohort study appears in the Journal of the American College of Radiology.

Blackmore and colleagues performed staged implementation of evidence-based clinical-decision support built into ordering systems for such selected high-volume imaging procedures as lumbar and brain MRIs and sinus CT. They used head CTs as controls, according to the abstract.

In determining imaging utilization rates and overall imaging utilization, the investigators found rates of imaging after the intervention were 23.4% lower for back pain lumbar MRI, 23.3% lower for headache head MRI and 26.8% lower for sinusitis sinus CT.

Head CT or control utilization rates were not significantly changed, based on the abstract.

“Clinical-decision support is potentially an ideal method for improving the evidence-based use of imaging,” Blackmore stated in the release. “Clinical-decision support systems have the desired properties of being educational, transparent, efficient, practical, and consistent. As our study suggests, the use of such systems can aid the elimination of unnecessary imaging, increasing both patient safety and quality and decreasing health care costs.”

Reference:
Blackmore CC. J Am Coll Radiol. 2011;8:19-25.
Disclosure: Blackmore has no relevant financial disclosures.

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