Electronic Health Record–Based Interventions for Improving Appropriate Diagnostic Imaging

Abstract

U.S. Department of Veterans Affairs. (PROSPERO registration number: CRD42014007469).

Evidence for overuse of medical services around the world

“…Additionally, EHRs have been used as tools to reduce overuse locally 199 and could be employed more broadly in the future. The last paper in this series, “Levers for Addressing Medical Underuse and Overuse: Achieving High-Value Health Care,” reviews efforts around the world to reduce overuse.…”

Evaluating the Effect of Unstructured Clinical Information on Clinical Decision Support Appropriateness Ratings

“…CDS has been proposed as a mechanism to maximize imaging appropriateness and efficient resource use by consistently ensuring that best practice criteria are implemented [2,14]. Indeed, integrating CDS into CPOE helps to reduce medical errors and improve provider performance in many settings outside of diagnostic imaging [1] and is one of the reasons for recent efforts to mandate CDS use for imaging [3].…”

“…Integrating these systems into the electronic health record may improve appropriate use and reduce overall volume of some types of imaging [2]. Possibly due to these considerations, Congress passed the Protecting Access to Medicare Act of 2014, which requires health care providers to consult "appropriate use criteria" using a "qualified decision support mechanism" when ordering advanced imaging for Medicare patients beginning in 2018 [3].…”

Meaningful Use of Electronic Health Records and Medicare Expenditures: Evidence from a Panel Data Analysis of U.S. Health Care Markets, 2010–2013

“…That imaging does not show a similar increase may be due to the countervailing effect of concern for patient welfare due to radiation exposure from some imaging procedures (Goldzweig et al. ).…”