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Abstract

Medical imaging is a tremendous diagnostic tool within medicine. The ability to non-invasively detect and screen for disease holds significant impact for medical or surgical treatment decisions. Monitoring of disease progression, whether infectious, inflammatory, or neoplastic is possible due to medical imaging. Over the years, access to medical imaging modalities such as X-ray, ultrasound, magnetic resonance (MR), computed tomography (CT), and positron-emission tomography (PET) has dramatically increased. In addition to expenditures related to pharmaceuticals, imaging is the next largest segment of costs for health plans, both private and public. As a result, significant growth of imaging utilization is a growing concern for healthcare. Appropriate utilization of imaging is a very important topic within healthcare utilization and optimization of decisions support systems, guidelines, and value-based imaging is critical to the future.

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References

  1. American College of Radiology of ACR Appropriateness Criteria. 2015. http://www.acr.org/quality-safety/appropreatness

  2. Stürzlinger H, Hiebinger C, Pertl D, Traurig P. Computerized physician order entry—effectiveness and efficiency of electronic medication ordering with decision support systems. GMS Health Technol Assess. 2009;5:Doc07. doi:10.3205/hta000069.

    PubMed  PubMed Central  Google Scholar 

  3. Bates DW, O’Neil AC, Boyle D, et al. Potential identifiability and preventability of adverse events using information systems. J Am Med Inform Assoc. 1994;1(5):404–11. https://pallas2.tcl.sc.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=7850564&site=ehost-live.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tierney WM, Miller ME, Overhage JM, McDonald CJ. Physician inpatient order writing on microcomputer workstations. Effects on resource utilization. JAMA. 1993;269:379–83. doi:10.1001/jama.269.3.379.

    Article  CAS  PubMed  Google Scholar 

  5. Hwang JI, Park HA, Bakken S. Impact of a physician’s order entry (POE) system on physicians’ ordering patterns and patient length of stay. Int J Med Inform. 2002;65:213–23. doi:10.1016/S1386-5056(02)00044-8.

    Article  PubMed  Google Scholar 

  6. Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280(15):1311–6. doi:10.1001/jama.280.15.1311.

    Article  CAS  PubMed  Google Scholar 

  7. Van Rosse F, Maat B, Rademaker CM, van Vught AJ, Egberts AC, Bollen CW. The effect of computerized physician order entry on medication prescription errors and clinical outcome in pediatric and intensive care: a systematic review. Pediatrics. 2009;123:1184–90. doi:10.1542/peds.2008-1494.

    Article  PubMed  Google Scholar 

  8. Holdsworth MT, Fichtl RE, Raisch DW, et al. Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients. Pediatrics. 2007;120:1058–66. doi:10.1542/peds.2006-3160.

    Article  PubMed  Google Scholar 

  9. Kaushal R, Jha AK, Franz C, et al. Return on investment for a computerized physician order entry system. J Am Med Inform Assoc. 2006;13(3):261–6. doi:10.1197/jamia.M1984.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc. 2008;15(5):585–600. doi:10.1197/jamia.M2667.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lobach DF, Hammond WE. Computerized decision support based on a clinical practice guideline improves compliance with care standards. Am J Med. 1997;102(1):89–98. doi:10.1016/S0002-9343(96)00382-8.

    Article  CAS  PubMed  Google Scholar 

  12. Garg AX, Adhikari NKJ, McDonald H, et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA. 2005;293(10):1223–38. doi:10.1001/jama.293.10.1223.

    Article  CAS  PubMed  Google Scholar 

  13. Hunt DL, Haynes RB, Hanna SE, Smith K. Effects of computer-based clinical decision support systems on physician performance and patient outcomes. JAMA. 1998;280(15):1339. doi:10.1001/jama.280.15.1339.

    Article  CAS  PubMed  Google Scholar 

  14. Coleman RW. Translation and interpretation: the hidden processes and problems revealed by computerized physician order entry systems. J Crit Care. 2004;19(4):279–82. doi:10.1016/j.jcrc.2004.09.001.

    Article  PubMed  Google Scholar 

  15. Wright A, Feblowitz JC, Pang JE, et al. Use of order sets in inpatient computerized provider order entry systems: a comparative analysis of usage patterns at seven sites. Int J Med Inform. 2012;81(11):733–45. doi:10.1016/j.ijmedinf.2012.04.003.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Teich JM, Spurr CD, Schmiz JL, O’Connell EM, Thomas D. Enhancement of clinician workflow with computer order entry. Proc Annu Symp Comput Appl Med Care. 1995;459–463.

    Google Scholar 

  17. Overhage JM, Perkins S, Tierney WM, McDonald CJ. Controlled trial of direct physician order entry: effects on physicians’ time utilization in ambulatory primary care internal medicine practices. J Am Med Inform Assoc. 2001;8(4):361–71. doi:10.1136/jamia.2001.0080361.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Aarts J, Koppel R. Implementation of computerized physician order entry in seven countries. Health Aff (Millwood). 2009;28(2):404–14. doi:10.1377/hlthaff.28.2.404.

    Article  Google Scholar 

  19. Niazkhani Z, Pirnejad H, Berg M, Aarts J. The impact of computerized provider order entry systems on inpatient clinical workflow: a literature review. J Am Med Inform Assoc. 2009;16(4):539–49. doi:10.1197/jamia.M2419.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Campbell EM, Guappone KP, Sittig DF, Dykstra RH, Ash JS. Computerized provider order entry adoption: implications for clinical workflow. J Gen Intern Med. 2009;24(1):21–6. doi:10.1007/s11606-008-0857-9.

    Article  PubMed  Google Scholar 

  21. Berger RG, Kichak JP. Computerized physician order entry: helpful or harmful? J Am Med Inform Assoc. 2004;11(2):100–3. doi:10.1197/jamia.M1411.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Bates DW, Kuperman GJ, Teich JM. Computerized physician order entry and quality of care. Qual Manag Health Care. 1994;2(4):18–27.

    Article  CAS  PubMed  Google Scholar 

  23. Weiner M, Gress T, Thiemann DR, et al. Contrasting views of physicians and nurses about an inpatient computer-based provider order-entry system. J Am Med Inform Assoc. 1999;6(3):234–44. doi:10.1136/jamia.1999.0060234.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Massaro TA. Introducing physician order entry at a major academic medical center: I. Impact on organizational culture and behavior. Acad Med. 1993;68(1):20–5.

    Article  CAS  PubMed  Google Scholar 

  25. Ash JS, Sittig DF, Poon EG, Guappone K, Campbell E, Dykstra RH. The extent and importance of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc. 2007;14(4):415–23. doi:10.1197/jamia.M2373.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Bobb AM, Payne TH, Gross PA. Viewpoint: controversies surrounding use of order sets for clinical decision support in computerized provider order entry. J Am Med Inform Assoc. 2007;14(1):41–7. doi:10.1197/jamia.M2184.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Campbell EM, Sittig DF, Ash JS, Guappone KP, Dykstra RH. Types of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc. 2006;13(5):547–56. doi:10.1197/jamia.M2042.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Pallin DJ, Sullivan AF, Espinola JA, Landman AB, Camargo CA. Increasing adoption of computerized provider order entry, and persistent regional disparities, in US emergency departments. Ann Emerg Med. 2011;58(6):543–50. doi:10.1016/j.annemergmed.2011.05.015. e3.

    Article  PubMed  Google Scholar 

  29. Kahn Jr CE, Messersmith RN, Jokich MD. PHOENIX: an expert system for selecting diagnostic imaging procedures. Invest Radiol. 1987;22(12):978–80.

    Article  PubMed  Google Scholar 

  30. Kahn Jr CE. Artificial intelligence in radiology: decision support systems. Radiographics. 1994;14:849–61. doi:10.1148/radiographics.14.4.7938772.

    Article  PubMed  Google Scholar 

  31. Greenes RA, Tarabar DB, Krauss M, et al. Knowledge management as a decision support method: a diagnostic workup strategy application. Comput Biomed Res. 1989;22(2):113–35. doi:10.1016/0010-4809(89)90021-9.

    Article  CAS  PubMed  Google Scholar 

  32. Khorasani R. Computerized physician order entry and decision support: improving the quality of care. Radiographics. 2001;21(4):1015–8. doi:10.1148/radiographics.21.4.g01jl371015.

    Article  CAS  PubMed  Google Scholar 

  33. Rosenthal DI, Weilburg JB, Schultz T, et al. Radiology order entry with decision support: initial clinical experience. J Am Coll Radiol. 2006;3(10):799–806. doi:10.1016/j.jacr.2006.05.006.

    Article  PubMed  Google Scholar 

  34. Raja AS, Ip IK, Prevedello LM, et al. Effect of computerized clinical decision support on the use and yield of CT pulmonary angiography in the emergency department. Radiology. 2012;262(2):468–74. doi:10.1148/radiol.11110951.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Vartanians VM, Sistrom CL, Weilburg JB, Rosenthal DI, Thrall JH. Increasing the appropriateness of outpatient imaging: effects of a barrier to ordering low-yield examinations. Radiology. 2010;255(3):842–9. doi:10.1148/radiol.10091228.

    Article  PubMed  Google Scholar 

  36. Juluru K, Eng J. Internet-based radiology order-entry, reporting, and workflow management system for coordinating urgent study requests during off-hours. AJR Am J Roentgenol. 2012;7:2127–34. http://www.ajronline.org.ezp-prod1.hul.harvard.edu. Accessed 19 Oct 2015.

    Google Scholar 

  37. Alkasab TK, Alkasab JR, Abujudeh HH. Effects of a computerized provider order entry system on clinical histories provided in emergency department radiology requisitions. J Am Coll Radiol. 2009;6(3):194–200. doi:10.1016/j.jacr.2008.11.013.

    Article  PubMed  Google Scholar 

  38. Sistrom CL, Dang PA, Weilburg JB, Dreyer KJ, Rosenthal DI, Thrall JH. Effect of computerized order entry with integrated decision support on the growth of outpatient procedure volumes: seven-year time series analysis. Radiology. 2009;251(1):147–55. doi:10.1148/radiol.2511081174.

    Article  PubMed  Google Scholar 

  39. Bowen S, Johnson K, Reed MH, Zhang L, Curry L. The effect of incorporating guidelines into a computerized order entry system for diagnostic imaging. J Am Coll Radiol. 2011;8(4):251–8. doi:10.1016/j.jacr.2010.11.020.

    Article  PubMed  Google Scholar 

  40. Blumenthal D. Launching HITECH. N Engl J Med. 2010;362(5):382–5. doi:10.1056/NEJMp0912825.

    Article  CAS  PubMed  Google Scholar 

  41. AC Radiology. ACR Select puts ACR appropriateness criteria at physicians’ fingertips. ACR Qual Saf eNews. 2013. http://www.acr.org/Quality-Safety/eNews/Issue-04-December-2013/ACR-Select. Accessed 19 Oct 2015.

  42. Lau L, Ng K-H, editors. Radiological safety and quality. Dordrecht: Springer Netherlands; 2014. doi:10.1007/978-94-007-7256-4.

    Google Scholar 

  43. Miller RA. Medical diagnostic decision support systems–past, present, and future: a threaded bibliography and brief commentary. J Am Med Inform Assoc. 1994;1(1):8–27. /pmc/articles/PMC116181/?report=abstract. Accessed 19 Oct 2015.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Georgiou A, Westbrook JI. Computerised order entry systems and pathology services--a synthesis of the evidence. Clin Biochem Rev. 2006;27(2):79–87. /pmc/articles/PMC1579412/?report = abstract. Accessed 19 Oct 2015.

    PubMed  PubMed Central  Google Scholar 

  45. Georgiou A, Williamson M, Westbrook J, Ray S. The impact of computerised physician order entry systems on pathology services: a systematic review. Int J Med Inform. 2007;76(7):514–29. doi:10.1016/j.ijmedinf.2006.02.004.

    Article  PubMed  Google Scholar 

  46. Mazzola L, Cavazzina A, Pinciroli F, et al. Towards a decision support system for hand dermatology. Stud Health Technol Inform. 2014;205:58–62. http://www.ncbi.nlm.nih.gov/pubmed/25160145. Accessed 19 Oct 2015.

    PubMed  Google Scholar 

  47. Papier A. Decision support in dermatology and medicine: history and recent developments. Semin Cutan Med Surg. 2012;31(3):153–9. doi:10.1016/j.sder.2012.06.005.

    Article  CAS  PubMed  Google Scholar 

  48. Fonseca E. On the cutting edge: using decision support tools to assess procedural appropriate use and increase healthcare value. HBS Open Forum 2014. Harvard Business School

    Google Scholar 

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Choy, G., Ryu, A. (2017). Utilization Management in Radiology. In: Lewandrowski, K., Sluss, P. (eds) Utilization Management in the Clinical Laboratory and Other Ancillary Services. Springer, Cham. https://doi.org/10.1007/978-3-319-34199-6_24

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  • DOI: https://doi.org/10.1007/978-3-319-34199-6_24

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