Adopting a Commercial Clinical Decision Support for Imaging Product: Our Experience

Abstract

WHY COMMERCIAL DECISION SUPPORT Clinical decision support (CDS) has emerged as a tool to improve patient care across many specialties [1]. Broadly defined, CDS is a method of delivering organized clinical knowledge and recommendations to a clinician to assist in selecting the best course of action for a specific clinical scenario. With regard to imaging, the purpose of CDS is to assist a referring physician in requesting the most appropriate imaging study for a specific clinical scenario [2]. CDS for imaging has been integrated into electronic ordering systems at other institutions with success. Some institutions have reported adoption across virtually all specialties, reduction in low-yield imaging, and even elimination of the need for preauthorization by thirdparty payers when using CDS [3-6]. Therefore, one can reasonably infer that a successful CDS system for imagingcouldnotonly improvepatientcare but might also aid in cost containment and compliance with meaningful use requirements [7,8]. As a result of the positive gains reported at other institutions, our department embraced CDS for computerized physician order entry (CPOE) of imaging studies. However, successful implementation of CDS into the CPOE for imaging studies has only been reported at institutions with “homegrown” CDS programs, which are programs developed by and for the institutions at which they were ultimately used, an approach that likely mitigated or eliminated many of the potential problems associated with CDSCPOE integration. The objective of this paper is to describe our experience at the University of Colorado attempting to integrate a third-party commercial CDS product into our health care system.