Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests

Claret, Pierre‐Géraud; Bobbia, Xavier; Macrì, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean‐Paul; Coussaye, Jean-Emmanuel de La

doi:10.1016/j.cmpb.2016.03.006

Cited by 8 publications

(1 citation statement)

References 18 publications

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“…56,57 CPOE and e-prescribing were identified as EHR features that generated efficiencies and reduced health care costs; higher use of CPOE was associated with a reduction in length of stay as well as decreased volume of labs and radiology requests. [58][59][60] Two studies found that e-prescribing may reduce medication costs by encouraging higher use of generic or formulary medications. 61,62 Despite these positive findings, some studies found that health IT and EHR adoption had either a negative effect or no impact on efficiency, showing a negative impact on productivity, increased medical costs, and no impact on reducing duplicate testing.…”

Section: Health Outcomes and Efficiencymentioning

confidence: 99%

A Decade of Health Information Technology and the Impact on Health Care in the U.S.: Systematic Review (Preprint)

Harris,

Goldwater,

Swain

et al. 2024

Preprint

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BACKGROUND In 2004, the Office of the National Coordinator for Health Information Technology (ONC) was established to facilitate the nationwide adoption and use of health information technology (health IT). Since its inception, the health IT landscape has evolved with a diverse array of federal investments, programs, and policies to advance its use. Previous systematic reviews of literature related to health IT focused on assessing the adoption and use of technology. As health IT has evolved, research has pivoted from tracking adoption of specific health IT features to assessing the impact of these technologies and tools. OBJECTIVE This paper provides a comprehensive review of peer-reviewed publications published over the past decade to closely examine the impacts of health IT including the impact of federal policies, changing priorities, and how the expanded use of EHR features, and effect of health IT on people, processes, and outcomes. METHODS All health IT-related peer-reviewed published between January 2013 and June 2023 were evaluated to identify articles that focused on the impact of health IT. Articles and studies were extracted through a review of PubMed. A stepwise process was used to identify articles that met the inclusion criteria, focused on the impact of health IT, and demonstrated sufficient scientific rigor. RESULTS The resulting 408 articles were coded based on their primary focus (provider-facing or patient-facing technology), or based on topics that pertained to the systemwide use of health IT. Within each of these categories, articles were organized around key themes. Overwhelmingly, research studies reported that health IT generated a positive impact. More than half of all articles focused on provider-facing technology with a focus on measurable outcomes including quality, safety, and costs. A number of studies evaluated the increased use of patient portals and other tools to support engagement. Studies on interoperability highlighted the value of increased health information exchange. An emerging area of study included a focus on the role of health IT in advancing public and population health. Over three-quarters of the published literature concluded that health IT generated a positive, mixed, or neutral impact. These effects were consistent across the different categories of health IT that were examined whether provider-facing, patient-facing, or systemwide impact of health IT. CONCLUSIONS Over the past decade, the focus of studies on the impact of health IT has evolved, transitioning from a concentration on health IT adoption to optimizing its potential. This includes assessing the effectiveness of EHR functions as well as increasing information exchange. As the landscape evolved with broader acceptance of health IT, the focus shifted with greater interest in technology’s impact on patient engagement, and opportunities to use data to advance health care including population and public health. CLINICALTRIAL N/A

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Section: Health Outcomes and Efficiencymentioning

confidence: 99%

A Decade of Health Information Technology and the Impact on Health Care in the U.S.: Systematic Review (Preprint)

Harris,

Goldwater,

Swain

et al. 2024

Preprint

View full text Add to dashboard Cite

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A New Proposed Model for the Influence of Climate Change on the Tension Anticipation in Hospital Emergencies

Mhimdi,

Ben Abdessalem

2024

Advances in Information Security

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Evaluating the Accuracy and Impact of the ESR-iGuide Decision Support Tool in Optimizing CT Imaging Referral Appropriateness

Luxenburg,

Vaknin,

Wilf-Miron

et al. 2024

J Digit Imaging. Inform. med.

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Radiology referral quality impacts patient care, yet factors influencing quality are poorly understood. This study assessed the quality of computed tomography (CT) referrals, identified associated characteristics, and evaluated the ESR-iGuide clinical decision support tool’s ability to optimize referrals. A retrospective review analyzed 300 consecutive CT referrals from an acute care hospital. Referral quality was evaluated on a 5-point scale by three expert reviewers (inter-rater reliability κ = 0.763–0.97). The ESR-iGuide tool provided appropriateness scores and estimated radiation exposure levels for the actual referred exams and recommended exams. Scores were compared between actual and recommended exams. Associations between ESR-iGuide scores and referral characteristics, including the specialty of the ordering physician (surgical vs. non-surgical), were explored. Of the referrals, 67.1% were rated as appropriate. The most common exams were head and abdomen/pelvis CTs. The ESR-iGuide deemed 70% of the actual referrals “usually appropriate” and found that the recommended exams had lower estimated radiation exposure compared to the actual exams. Logistic regression analysis showed that non-surgical physicians were more likely to order inappropriate exams compared to surgical physicians. Over one-third of the referrals showed suboptimal quality in the unstructured system. The ESR-iGuide clinical decision support tool identified opportunities to optimize appropriateness and reduce radiation exposure. Implementation of such a tool warrants consideration to improve communication and maximize patient care quality.

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Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests

Cited by 8 publications

References 18 publications

A Decade of Health Information Technology and the Impact on Health Care in the U.S.: Systematic Review (Preprint)

A Decade of Health Information Technology and the Impact on Health Care in the U.S.: Systematic Review (Preprint)

A New Proposed Model for the Influence of Climate Change on the Tension Anticipation in Hospital Emergencies

Evaluating the Accuracy and Impact of the ESR-iGuide Decision Support Tool in Optimizing CT Imaging Referral Appropriateness

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