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

Amazon Comprehend Medical Brings Medical Language Processing to Healthcare
News | Artificial Intelligence | February 15, 2019
Amazon recently announced Amazon Comprehend Medical, a new HIPAA-eligible machine learning service that allows...
Siemens Healthineers Demonstrates Artificial Intelligence, Healthcare Digitalization at HIMSS19
News | Artificial Intelligence | February 13, 2019
February 13, 2019 — At the 2019 Healthcare Information and Management Systems Society (HIMSS) global conference and e
New Appropriate Use Criteria Outlined for Multimodality Imaging of Nonvalvular Heart Disease
News | Cardiac Imaging | February 11, 2019
The American College of Cardiology (ACC), along with nine other cardiology professional societies, recently published a...
IMS to Unveil Prototype Imaging Machine Learning Platform at HIMSS19
News | Artificial Intelligence | February 06, 2019
International Medical Solutions (IMS) announced a solution that will enable radiologists and other clinicians to use...
Siemens Healthineers Syngo.Breast Care Adding AI-Based Decision Support
News | Clinical Decision Support | February 05, 2019
Siemens Healthineers showcased the new planned artificial intelligence (AI)-based features with its mammography reading...
Infinitt Showcases New RIS/PACS Features at RSNA 2018
News | PACS | December 19, 2018
Infinitt North America highlighted a range of healthcare information technology (IT) products and applications at the...
ScreenPoint Medical and Volpara Partner to Bring AI to Breast Imaging Clinics
News | Computer-Aided Detection Software | December 04, 2018
ScreenPoint Medical has signed a memorandum of understanding (MOU) with Volpara Health Technologies. Volpara will...
ScreenPoint Medical Receives FDA Clearance for Transpara Mammography AI Solution
Technology | Computer-Aided Detection Software | November 28, 2018
November 28, 2018 — ScreenPoint Medical announced it has received 510(k) clearance from the U.S.
Volpara Solutions Showcases Latest VolparaEnterprise Software Tools at RSNA
News | Mammography | November 21, 2018
Volpara Solutions Inc. will showcase its latest artificial intelligence (AI) updates at the 104th Annual Radiological...
Guerbet Showcases Ongoing Collaboration With IBM Watson at RSNA 2018
News | Clinical Decision Support | November 21, 2018
Guerbet LLC USA will feature its digital solutions including its ongoing collaboration with IBM Watson Health in...