When analyzing early data during their institution's implementation of radiology clinical decision support (CDS), researchers at Einstein Health Network in Philadelphia noted an interesting trend toward higher levels of appropriate ordering by pilot users after CDS had been in place for a period of time. This suggests that physicians learned through experience with CDS what the most appropriate studies were for given indications, said lead study author Dr. Ryan Lee.
This possible educational benefit from decision support had not been previously described, to the best of their knowledge, so Lee and co-author and presenter Dr. Bryan Kang elected to more formally investigate this phenomenon. They calculated the number of ordered studies that did not require intervention by the CDS software -- and were, therefore, considered appropriate -- during a four-month period following implementation, as well as during the following three months. The percentage of imaging orders considered appropriate by decision-support software increased significantly in the subsequent period, according to the researchers.
The preliminary results of the study show that radiology CDS may also bring educational benefits, in addition to its known benefits of providing clinicians with a tool for appropriate ordering of imaging studies and for managing utilization, Lee said.
"Since most physicians have a base set of studies they typically order given the type of practice they have, it would make sense that as CDS suggests the same set of appropriate studies for their practice, they would, in turn, learn what these studies are for indications they commonly see -- resulting in fewer inappropriate studies ordered over time," Lee said. "Thus, simply having radiology CDS can have an educational effect for ordering clinicians."
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