Difference between revisions of "Radiology order decision support: examination-indication appropriateness assessed using 2 electronic systems"

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== Introduction ==
 
== Introduction ==
The authors refer to several previous studies pointing out that the ise of IT in healthcare resulted in practitioner performance improvements, complication and mortality rate reductions, and decrease of cost. This stidy was conducted to determine the effects of guideline implementation strategy using 2 commercial radiology clinical decision support (CDS) systems. The authors looked for exam appropriateness, insurance approvals, and user satisfaction..<ref name="Radiology">Schneider E, Zelenka S, Grooff P, Alexa D, Bullen J, Obuchowski N. Radiology order decision support: examination-indication appropriateness assessed using 2 electronic systems. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pubmed/25842015</ref>
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The authors refer to several previous studies pointing out that the ise of IT in healthcare resulted in practitioner performance improvements, complication and mortality rate reductions, and decrease of cost. This stidy was conducted to determine the effects of guideline implementation strategy using 2 commercial radiology clinical decision support ([[CDS]]) systems. The authors looked for exam appropriateness, insurance approvals, and user satisfaction..<ref name="Radiology">Schneider E, Zelenka S, Grooff P, Alexa D, Bullen J, Obuchowski N. Radiology order decision support: examination-indication appropriateness assessed using 2 electronic systems. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pubmed/25842015</ref>
  
 
== Methods ==
 
== Methods ==

Revision as of 16:24, 17 October 2015

This article was published in 2015 in Journal of the American College of Radiology

Introduction

The authors refer to several previous studies pointing out that the ise of IT in healthcare resulted in practitioner performance improvements, complication and mortality rate reductions, and decrease of cost. This stidy was conducted to determine the effects of guideline implementation strategy using 2 commercial radiology clinical decision support (CDS) systems. The authors looked for exam appropriateness, insurance approvals, and user satisfaction..[1]

Methods

The study was conducted at three stand-alone outpatient imaging centers that perform MRI and CT examinations. Twp CDS systems,Medicalis SmartReq and Nuance RadPor, were used to evaluate the appropriateness and insurance dispositions of MRI and CT orders during 2 different 3-month periods.

Results

The study evaluated approximately 2,000 outpatient MRI and CT orders. One system, Nuance, showed significantly better result in scoring exams as appropriate (80% versus 51%, P < .001). This system also had better outcomes in predicting insurance reimbursement (76% versus 58%, P < .001). 19% of exams with low-utility rating were reimbursed; and only 0.8% of high- and moderate-utility exams were denied reimbursement.

Conclusion

The authors state that the difference between the 2 CDS systems was how they handle exams without relevant guidelines or with insufficient information. The better-performing system combined published guidelines with clinical best practice. The other system requested additional information utilizing pop-up windows. Decision making and outcomes were affected by guidelines implementation choices. The authors argue that simpler and easier user experience can lead to better system ratings and willingness to use CDS.

Comments

This study confirmed again that developers should be paying much attention to user interface design. Collecting feedback from test users should be done prior to implementation.

References

  1. Schneider E, Zelenka S, Grooff P, Alexa D, Bullen J, Obuchowski N. Radiology order decision support: examination-indication appropriateness assessed using 2 electronic systems. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pubmed/25842015