Andrew K Moriarity1, Chad Klochko2, Matthew O'Brien2, Safwan Halabi2. 1. Department of Diagnostic Radiology, Henry Ford Health System, Detroit, Michigan. Electronic address: andymoriarity@gmail.com. 2. Department of Diagnostic Radiology, Henry Ford Health System, Detroit, Michigan.
Abstract
PURPOSE: To examine the effect of integrating point-of-care clinical decision support (CDS) using the ACR Appropriateness Criteria (AC) into an inpatient computerized provider order entry (CPOE) system for advanced imaging requests. METHODS: Over 12 months, inpatient CPOE requests for nuclear medicine, CT, and MRI were processed by CDS to generate an AC score using provider-selected data from pull-down menus. During the second 6-month period, AC scores were displayed to ordering providers, and acknowledgement was required to finalize a request. Request AC scores and percentages of requests not scored by CDS were compared among primary care providers (PCPs) and specialists, and by years in practice of the responsible physician of record. RESULTS: CDS prospectively generated a score for 26.0% and 30.3% of baseline and intervention requests, respectively. The average AC score increased slightly for all requests (7.2 ± 1.6 versus 7.4 ± 1.5; P < .001), for PCPs (6.9 ± 1.9 versus 7.4 ± 1.6; P < .001), and minimally for specialists (7.3 ± 1.6 versus 7.4 ± 1.5; P < .001). The percentage of requests lacking sufficient structured clinical information to generate an AC score decreased for all requests (73.1% versus 68.9%; P < .001), for PCPs (78.0% versus 71.7%; P < .001), and for specialists (72.9% versus 69.1%; P < .001). CONCLUSIONS: Integrating CDS into inpatient CPOE slightly increased the overall AC score of advanced imaging requests as well as the provision of sufficient structured data to automatically generate AC scores. Both effects were more pronounced in PCPs compared with specialists.
PURPOSE: To examine the effect of integrating point-of-care clinical decision support (CDS) using the ACR Appropriateness Criteria (AC) into an inpatient computerized provider order entry (CPOE) system for advanced imaging requests. METHODS: Over 12 months, inpatient CPOE requests for nuclear medicine, CT, and MRI were processed by CDS to generate an AC score using provider-selected data from pull-down menus. During the second 6-month period, AC scores were displayed to ordering providers, and acknowledgement was required to finalize a request. Request AC scores and percentages of requests not scored by CDS were compared among primary care providers (PCPs) and specialists, and by years in practice of the responsible physician of record. RESULTS: CDS prospectively generated a score for 26.0% and 30.3% of baseline and intervention requests, respectively. The average AC score increased slightly for all requests (7.2 ± 1.6 versus 7.4 ± 1.5; P < .001), for PCPs (6.9 ± 1.9 versus 7.4 ± 1.6; P < .001), and minimally for specialists (7.3 ± 1.6 versus 7.4 ± 1.5; P < .001). The percentage of requests lacking sufficient structured clinical information to generate an AC score decreased for all requests (73.1% versus 68.9%; P < .001), for PCPs (78.0% versus 71.7%; P < .001), and for specialists (72.9% versus 69.1%; P < .001). CONCLUSIONS: Integrating CDS into inpatient CPOE slightly increased the overall AC score of advanced imaging requests as well as the provision of sufficient structured data to automatically generate AC scores. Both effects were more pronounced in PCPs compared with specialists.
Authors: Weihan Chen; David T Saxon; Michael P Henry; John R Herald; Rob Holleman; Debbie Zawol; Stacy Sivils; Mohamad A Kenaan; Theodore J Kolias; Hitinder S Gurm; Nicole M Bhave Journal: J Am Soc Echocardiogr Date: 2020-11-01 Impact factor: 5.251
Authors: Islam Y Elgendy; Ahmed Mahmoud; Jonathan J Shuster; Rami Doukky; David E Winchester Journal: J Nucl Cardiol Date: 2015-08-08 Impact factor: 5.952
Authors: Madan M Rehani; Emily R Melick; Raza M Alvi; Ruhani Doda Khera; Salma Batool-Anwar; Tomas G Neilan; Michael Bettmann Journal: Eur Radiol Date: 2019-12-02 Impact factor: 5.315
Authors: Leonid L Chepelev; Xuan Wang; Benjamin Gold; Clara-Lea Bonzel; Frank Rybicki; Jennifer W Uyeda; Adnan Sheikh; Dan Anderson; Jared Lindaman; Greg Mogel; Dimitrios Mitsouras; Mary C Mahoney; Tianxi Cai; Frank J Rybicki Journal: J Digit Imaging Date: 2021-02-25 Impact factor: 4.056