Large 10-Year Study Shows Electronic Ordering with Imaging Decision Support is Well Accepted

A study that looked at 4.1 million imaging studies performed at Brigham and Women’s Hospital in Boston between 2000 and 2010 indicates that fears that clinicians may reject electronic ordering of imaging studies with built-in computerized decision support may be unfounded. The study, which appears in the February issue of the Journal of the American College of Radiology, found that implementing a computerized physician order entry (CPOE) system with clinical decision support for radiology had many benefits for the organization and potentially patients as well. Applying statistical analysis methods to the more than 4 million studies done at the hospital in 10 years, the researchers noted that the meaningful use criteria of electronically created orders and electronically signed studies increased significantly. In 2000, only 0.4 percent of imaging study orders were created electronically. By 2010, this had increased to 61.9 percent across the board with even higher percentages for clinicians in the emergency department and in the in-patient setting. (Surgical subspecialties had the lowest use of electronically created imaging study orders.) And it was not just the ordering clinicians who were getting on board. The radiologists interpreting the studies went from almost no studies (0.4 percent) being signed electronically to almost every study (92.2 percent) being signed electronically. Equally important, computerized imaging ordering with embedded decision support integrated into the IT infrastructure of the health care enterprise and clinicians' workflow had potential benefits for patients. A press release accompanying the study noted that "meaningful use of health care IT can improve patient safety, efficiency and the quality of care. Initial studies have showed that with decision support, the percentage of low-utility imaging studies may decrease by as much as 57 percent." "Our study shows that an imaging CPOE system with embedded decision support that is integrated into the health care enterprise IT infrastructure…can be successfully and broadly accepted clinically," said Ivan K. Ip, MD, MPH, lead author of the study, said in the release.View the study abstract.