Decision support tools embedded in electronic ordering systems can help improve appropriate utilization of imaging procedures, say researchers at Massachusetts General Hospital, Boston. Speaking at an RSNA 10-minute mini-session, Supria Gupta, M.D., a research fellow at the academic medical center, outlined how a decision support tool that evaluated the need for CT and MRI scans of the abdomen helped physicians make more effective use of the costly procedures. According to Gupta, the higher the decision support score--which is based on guidelines from the American Cancer Society--the more likely the test ultimately revealed significant positive findings.

In a related presentation, Vartan Vartanians, M.D., noted how the electronic radiology order entry system also offered similar decision support tools for MRI breast exams. The decision support technology was embedded in the hospital's EHR set-up about six years ago. The ordering system also includes a link to a lifetime risk calculator for breast cancer. After implementing the support tools, the overall number of MRI breast exams decreased by about 12 percent over a 10-year period that was the subject of Vartanians' research. The system also suggests alternative tests for physicians to consider, and in all cases, the ordering physician can over-ride the alert if the system suggests low utility for a given test.

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