Purpose or learning objective
[ESR iGuide logo]
ESR iGuide is the European Society of Radiology's (ESR) clinical decision support (CDS) system for medical imaging referrals. ESR iGuide uses imaging referral guidelines developed by the ESR based on the American College of Radiology Appropriateness Criteria (ACR AC).
The ESR advocates the use of CDS integrated into existing imaging referral workflows to support healthcare providers with evidence-based guidelines, aimed at utilising medical imaging more efficiently and appropriately for the benefit of patients. The aim of the ESR iGuide initiative is to...
Methods or background
The case for CDS
Among their many benefits, clinical decision support systems impact two key areas of concern that are highlighted repeatedly in scientific and professional literature: the appropriateness of imaging exam selection, and the quality of information provided in referrals.
For example, this was confirmed in a study from Portugal published in January 2020, which revealed that 25 percent of referrals were deemed inappropriate, while only 15 percent (!) of referrals were considered to have complete clinical information.1
The study also highlighted one of...
Results or findings
ESR iGuide implementation
As the need for CDS adoption and the benefits of implementation gain recognition, the ESR would like to provide some information on the implementation process of ESR iGuide and a few examples of ongoing projects.
The implementation of ESR iGuide in one healthcare organisation is typically a project with a duration between three to five months, containing the following phases:
Phase 0: Preparatory phase and scope definition
Phase 1: Procedure mapping preparation, system build, testing
Phase 2: Mapping organisational procedures to ESR...
Conclusion
With the increased number of publications and studies from both health professionals and medical researchers, there is growing recognition of the need to incorporate evidence-based guidance for imaging referrals in clinical practice. Integrated decision support solutions are the most effective way of doing so in a user-friendly way.
Driving the adoption of evidence-based clinical decision support for medical imaging in Europe is a major part of the ESR's mission to ensure the highest quality and safety of patient care in radiology across Europe and beyond....
References
1) Rute MARTINS, Pedro RAIMUNDO, Pedro ALVES, Rodrigo MONTEIRO, Luís Duarte SILVA, André GOMES, Graça AFONSO. Appropriateness of Radiology Test Requests by an Emergency Department: A Retrospective Study. Acta Med Port 2020 Jan;33(1):7-14. https://doi.org/10.20344/amp.12075.
2) Prevedello, L. et.al. (2013). Does Clinical Decision Support Reduce Unwarranted Variation in Yield of CT Pulmonary Angiogram? In Am J Med. 2013 Nov; 126(11): 975-981. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438082/
3) Raja, A. et.al. (2012). Effect of Computerized Clinical Decision Support on the Use and Yield of CT Pulmonary Angiography in the...
Personal information and conflict of interest
F. Demuth:
Nothing to disclose