'Accountability tool' reduces CT scans in the ER

A tool embedded in an electronic health record can reduce the number of CT scans performed in the emergency room and help patients avoid unnecessary radiation, concludes a University of Pennsylvania Perelman School of Medicine study. Abdominal pain is the most common reason for emergency room visits in the United States; since diagnosis is often difficult, many patients receive CT scans, even though in many instances the scan--and the radiation--turns out to have been unnecessary.

In the study of 11,176 patients in two University of Pennsylvania emergency rooms, the researchers used an embedded "accountability tool" in the EHR system to walk the physicians through a series of questions that served as a checks and balances to decide whether the patient should receive a CT scan. Use of the tool caused the number of patients receiving CT scans to drop 10 percent, without increasing the number of patients admitted to the hospital, which is common when the diagnosis is unclear.  

"For many patients, like those who are older or have cancer, this tool might not make a difference, but there are many abdominal patients who are younger, healthier, and who have things that are usually not life-threatening like kidney stones, for whom we are hoping this will reduce their exposure to unnecessary radiation,' Angela Mills, assistant professor of emergency medicine and medical director at the Hospital of the University of Pennsylvania, said in a statement.

Radiation overexposure in the emergency room has long been a major patient safety issue. Other studies have indicated that similar screening clinical decision support tools can help physicians improve patient health, especially in a busy environment such as an emergency room or pediatric clinic.  

To learn more:
- here's the announcement from the University of Pennsylvania
- read more about the dangers of CT scans
- here's the abstract of the pediatric clinic study
- check out the Medscape Medical News article