News | May 25, 2010

Low-Yield Exams Drop 3.5 Percent Using Decision Support

May 25, 2010 - May 25, 2010 - Radiologists using decision support helped decrease the percentage of low-yield exams from 5.4 percent of total number of requests to 1.9 percent of total requests, according to a study appearing in the June issue of Radiology.

The study, “Increasing the Appropriateness of Outpatient Imaging: Effects of a Barrier to Ordering Low-Yield Examinations," measured how a new rule preventing medical support staff from completing orders for outpatient imaging exams that were likely to be negative resulted in a marked decrease in low-yield exams for patients.

Many medical institutions request and schedule outpatient diagnostic imaging exams through use of web-based radiology order entry systems. Some systems offer real-time feedback, called decision support, on the appropriateness of the exams being ordered. When entering the desired examination into the system, the physician or support staff must also enter clinical information justifying the order. Based on that information, the decision-support system provides a yield score ranging from one to nine. The score indicates the likelihood that the selected exam will yield valuable diagnostic or positive results for this set of clinical circumstances.

Following American College of Radiology appropriateness criteria, a score of one to three is considered low yield. The user is then given the opportunity to cancel the order or select a different examination. However, because medical support staff do not make clinical decisions, they are less likely to cancel or revise an order without additional clarification from the physician.

To address this problem, Massachusetts General Hospital instituted a rule preventing medical support staff from completing computerized orders for outpatient CT, MRI and nuclear medicine examinations that received low-yield decision support scores.

“We developed this strategy to encourage more clinician ‘hands-on’ use of the system,” said Vartan M. Vartanians, M.D., clinical research associate in the Department of Radiology at Massachusetts General Hospital in Boston. “With greater physician involvement, fewer low-yield exams are ordered.”

After the change, the proportion of total examination requests by physicians directly logging into the system more than doubled from 26 percent to 54 percent of the total number of requests, while the percentage of low-yield exams requested decreased from 5.4 percent of total number of requests to 1.9 percent of total requests.

“Physicians need to use the decision support system for it to be effective, but getting them to do so can be difficult,” Dr. Vartanians said. “Our work demonstrates that a minimally disruptive alteration in the radiology order entry system can encourage direct physician involvement, and improve patient care by reducing the number of low-yield examinations.”

Reference: “Increasing the Appropriateness of Outpatient Imaging: Effects of a Barrier to Ordering Low-Yield Examinations.” Collaborating on this paper with Dr. Vartanians were Christopher L. Sistrom, M.D., M.P.H., Jeffrey B. Weilburg, M.D., Daniel I. Rosenthal, M.D., and James H. Thrall, M.D. Radiology.

For more information: www.rsna.org

Related Content

Sponsored Content | Videos | Business | July 28, 2017
Angelic McDonald, MSRS, CRA, FAHRA, regional director of imaging, Baylor Scott & White Health and the president-e
CareSelect Declared Fully Qualified Clinical Decision Support Mechanism by CMS
News | Clinical Decision Support | July 18, 2017
National Decision Support Company announced the full qualification of its CareSelect Platform as a Qualified Clinical...
CMS Proposes Delaying Clinical Decision Support Documentation to 2019
News | Clinical Decision Support | July 14, 2017 | Jeff Zagoudis, Associate Editor
In a series of proposed rule changes to the Medicare Physician Fee Schedule (MPFS) released July 13, the Centers for...
News | Artificial Intelligence | July 07, 2017
July 7, 2017 — Zebra Medical Vision and Telerad Tech, the technology arm of Teleradiology Solutions (TRS), announced
ACR Launches Updated LI-RADS for Liver Imaging
News | Clinical Decision Support | July 06, 2017
July 6, 2017 — Radiologists can improve their consistency of interpreting and reporting...
Sponsored Content | Videos | Clinical Decision Support | June 29, 2017
Rami Doukky, M.D., system chair, Division of Cardiology, professor of medicine, Cook County Health and Hospitals Syst
Fujitsu Develops AI-Based Technology to Retrieve Similar Disease Cases in CT Inspections

Newly developed technology to retrieve similar cases. Image courtesy of Fujitsu.

News | Artificial Intelligence | June 26, 2017
Fujitsu Laboratories Ltd. announced development of a technology to retrieve similar disease cases from a computed...
Siemens Healthineers and Fraunhofer MEVIS Announce Research Alliance on Clinical Decision Support
News | Clinical Decision Support | May 31, 2017
Siemens Healthineers and the Fraunhofer Institute for Medical Image Computing MEVIS announced the formation of a new...
ACR Highlights Initial Results of R-SCAN Program at 2017 Annual Meeting
News | Clinical Decision Support | May 22, 2017
The American College of Radiology (ACR) announced a series of sessions at the 2017 Annual Meeting that will highlight...
Partners HealthCare and GE Healthcare Launch 10-Year Collaboration on Artificial Intelligence
News | Artificial Intelligence | May 17, 2017
Partners HealthCare and GE Healthcare announced a 10-year collaboration to rapidly develop, validate and strategically...
Overlay Init