How to make CDS tools more effective for radiologists

The ideal clinical decision support system should reduce healthcare costs, patient radiation exposure and patient evaluation time without compromising healthcare standards or a patient's quality of life, according to an article in the March issue of the Journal of the American College of Radiology.

According to authors Joshua Broder, M.D., of Duke University Medical Center and Safwan Halabi, M.D., of Henry Ford Health System in Detroit, CDS will become "a cornerstone in the pursuit of outcomes-based healthcare and the delivery of best practices" as care shifts toward a pay-for-performance model. 

The ideal CDS system also should be evidence-based, user friendly and flexible enough to allow physician judgment to override the system in cases where clinical factors exist that aren't being considered by the CDS, according to the authors.

The increasing use of electronic health records and electronic order entry make it possible for CDS systems to import individual patient data--such as history, medications, demographic and laboratory information, and vital signs--and automatically inform the physician when an applicable decision support algorithm exists.

Ideally, write the authors, clinical decision support is embedded in the ordering process, giving physicians the means to terminate imaging orders as an order is being entered if the CDS system suggests that imaging isn't necessary. They point out that with the implementation of Meaningful Use, there has "been a rush of health care providers and institutions investing in medical technologies that include EHRs and computerized physician order entry."

This shift from manual to electronic entry for imaging studies, the authors say, has provided an opportunity to make imaging guidelines accessible interactively rather than in some kind of static, reference form, enabling providers to get real time advice and recommendations at the time of order entry.

Radiologist Matt Hawkins wrote for FierceMedicalImaging about the growing importance of clinical decision support tools in the radiology industry following the Radiological Society of North America's annual conference in Chicago in December. Hawkins, a vascular interventional radiology fellow at the University of Washington/Seattle Children's Hospital, said that CDS software will provide "a much-needed infusion of utilization guidelines into" healthcare.

"Based on multi-specialty, evidence-based peer-reviewed literature, these guidelines inform user-friendly interfaces for referring clinicians that aide in ensuring the right test is ordered for the current clinical scenario," Hawkins wrote. "Rather than trying to reduce utilization, decision-support software will optimize imaging resource utilization. A better end-result for our patients and our health system."

To learn more:
- read the article in JACR

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