Computerized ordering reduces radiology study turnaround

Computerized physician order entry (CPOE) systems can dramatically reduce the times required to complete imaging procedures such as x-rays, a pair of studies has found.

One paper (J Am Med Inform Assoc 2002;9(5):529-39) suggests that hospitals can cut the time it takes to complete radiological studies, obtain lab tests, and deliver medications to patients significantly by having doctors fill out orders via computer rather than by hand.

Aside from the obvious benefit of eliminating prescription drug errors associated with handwritten prescriptions, the study found that CPOE cut turnaround times for x-rays and other radiology procedures by 43% from just over seven and a half hours to four hours and 21 minutes. Medication turnaround times were cut by 64% from nearly five and a half hours to just under two hours, and lab test times reduced by 25% from 31 minutes to 23 minutes.

Another study, presented at the January meeting of the Society for Critical Care Medicine, showed that an order entry system implemented at Cincinnati Children's Hospital Medical Center significantly reduced the time it takes to obtain radiology film on patients in the pediatric intensive care unit and to receive oral reports from the radiologist.

The CPOE system reduced the time of arrival to take the x-ray from 18 to eight minutes (56%) and the time the x-ray was available for viewing from 33 to 24 minutes (25%).

All patient orders - radiology studies, medications, special diets, laboratory studies, tests, and consultations - are included in the system.

Stat radiology orders, for example, are electronically routed to a pager carried by a radiology technician. The system resulted in fewer phone calls between clinicians and radiologists to either clarify or augment information. User satisfaction surveys indicated that physicians, radiologists, and radiology technicians are pleased with it.

Still, clinical guidelines may outpace CPOE systems in 2003 as providers' choice for reducing medical errors, according to Forrester Research in its annual top 10 predictions for healthcare released earlier this month. It predicted that strategies for medical error reduction will include best practice guidelines and clinical decision support, not CPOE.