Clinical Decision Support (CDS) for Radiology Imaging

Summary

The goal of the study is to determine whether clinical decision support (CDS) for radiology affects the number, type, or appropriateness of targeted high-cost radiology imaging orders (i.e. magnetic resonance (MR), computed tomography (CT), nuclear medicine (NM) and Positron Emission Tomography (PET) scans). The CDS will be delivered to physicians in the Aurora Health Care system. It will be delivered in Epic, an industry-standard electronic medical record software, through ACR Select, which is a leading decision support tool based on the American College of Radiology (ACR) Appropriateness Criteria (see http://www.acr.org/Quality-Safety/Appropriateness-Criteria). The ACR Select tool rates imaging orders on a scale of 1-9 with 1-3 labelled as 'usually not appropriate', 4-6 'May be appropriate', and 7-9 'usually appropriate'.

Conditions

• CT, MR, NM, and PET Image Orders

Interventions

OTHER

Clinical Decision Support (CDS)

A best practices alert (BPA) pop-up screen providing CDS will appear at physician sign-off for all scans scored 1-6, and scans scored 7-8 for which an alternative scan scored 8-9 exists. This screen will show the appropriateness score of the original scan order, and will display up to 7 alternative scans that are scored \>4 and greater than or equal to the original score for the same indications and patient characteristics. It will also display a link to relevant ACR documentation relevant to the selected scan and indication.

Sponsors & Collaborators

• Wake Forest University Health Sciences

  collaborator OTHER

• Laura and John Arnold Foundation

  collaborator OTHER

• Massachusetts Institute of Technology

  collaborator OTHER

• Abdul Latif Jameel Poverty Action Lab

  lead OTHER

Principal Investigators

• Joseph Doyle, PhD · Massachusetts Institute of Technology

• Amy Finkelstein, PhD · Massachusetts Institute of Technology

• Sarah Reimer, MD · Wake Forest University Health Sciences

• Laura Feeney, MA · Massachusetts Institute of Technology

• Sarah Abraham · Massachusetts Institute of Technology

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-12-15

Primary Completion

2018-12-31

Completion

2018-12-31

Countries

• United States

Study Locations