Effects of a Computerized Provider Order Entry System on Clinical Histories Provided in Emergency Department Radiology Requisitions

Abstract

The provided clinical history can affect the interpretation of radiologic examinations, especially in the emergency department context. The aim of this study was to evaluate the effects of computerizing the radiology requisition process on the information contained in provided clinical histories. Requests for abdominal computed tomographic examinations from the emergency department for 10-day periods before and after the switch from a paper-based to a computerized requisition system were examined. Requisitions were individually rated for information on signs and symptoms, prior diagnoses, abnormal test results, and clinical questions. Post hoc analysis of the lengths of provided histories was also performed. Requests from the computerized system were significantly more likely than paper-based requests to contain clinical questions (52.6% vs 34.8%; P < .0001) or information on prior diagnoses (71.1% vs 51.1%; P = .0027). No significant difference was seen for information regarding signs and symptoms or abnormal test results. Computerized histories also tended to be longer then paper-based histories (71.2 vs 49.6 characters). A computerized radiology requisition system can result in more clinical history information being provided. Radiologists should seek to further improve the interfaces with which referring physicians provide such information and test that these refinements are having the desired effect.