Congress:
EuroSafe Imaging 2021
Keywords:
Computer applications, RIS, Computer Applications-General, Patterns of Care
DOI:
10.26044/esi2021/ESI-11617
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 the main arguments for improved appropriateness: the odds ratio of having a relevant finding was five times higher in tests considered appropriate.1
This is in line with studies from the US, indicating that diagnostic yield in performed exams considered appropriate at the point of referral is significantly higher.2 3
Another recent study focusing on the emergency department suggests that clinical decision support could boost the appropriate use of CT for diagnosing appendicitis in children.4
Similar trends with respect to the need for better quality and clarity of referral information were described in a Philips publication in 2019 ("Radiology staff in focus"). This paper identified the need to improve the information received in patient referrals as a key factor in improving the work of radiology departments. According to this workload survey, "access to the right information at the right time" is the factor with the biggest gap between satisfaction and importance among radiology staff.5
Clinical decision support systems can help alleviate these problems, as they introduce structured imaging referrals that provide at least one clear, structured clinical indication as a reason for exam for patient referrals, in addition to providing referrers with actionable, evidence-based guidance in real time that will help improve the appropriateness of requested exams.