Electronic decision support for diagnostic imaging in a primary care setting |
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Authors: | Lynn Curry Martin H Reed |
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Institution: | 1.CurryCorp, Ottawa, Ontario, Canada;2.Diagnostic Imaging, Health Sciences Centre, Children''s Hospital, Winnipeg, Manitoba, Canada |
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Abstract: | MethodsClinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines.ResultsOf those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software.ConclusionsPhysicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow. |
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Keywords: | Decision support guidelines diagnostic imaging family practice rural catchment area practice change clinical decision support machine learning clinicial guidelines diagnostic imaging rural practice |
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