Order entry system attacks wasteful imaging referrals

Two years of experience with Massachusetts General Hospital’s radiology order entry system indicate the decision-support features embedded in the software cut down on inappropriate image utilization. They also help referring doctors learn the most appropriate imaging application for specific symptomatic indications.

MGH fellow Pragya Dang conducted an evaluation of the system from the fourth quarter of 2004 to the fourth quarter of 2006. Dang found low-utility CT exams decreased from 11% of the total volume before implementation to 4% by the end of the study period. High-utility CT exams rose significantly in the same period, from 86% before implementation to 93% after referrers learned to use the system.

The same trend was seen for MR utilization. Clinical indications with the highest prevalence of inappropriate study order patterns included dementia, syncope, chronic headache, and back pain. Dang reported the results at the 2007 RSNA meeting.