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New Rule Reduces Low-Yield Outpatient Imaging Exams

Change in order entry system increases percentage of tests personally ordered by physicians

TUESDAY, May 25 (HealthDay News) -- A rule that prevents medical support staff from completing computerized orders for outpatient imaging exams that have a high likelihood of being negative results in fewer low-yield examinations and an increased percentage of tests ordered by clinicians themselves, according to a study in the June issue of Radiology.

Vartan M. Vartanians, M.D., of Harvard Medical School and Massachusetts General Hospital in Boston, and colleagues assessed implementation of a new rule for imaging requests placed into an order entry system by evaluating 42,737 consecutive orders for examination in which decision support was provided from April to December 2006 (control group) and 76,238 consecutive orders that were placed from April to December 2007 after the new rule was implemented (study group).

The researchers found that the proportion of total examination requests started by physicians directly logging into the system increased from 26.31 percent of examinations to 54.37 percent after implementation of the new rule. Low-yield exams requested that were later scheduled and performed decreased from 5.43 to 1.92 percent.

"Our work demonstrates that a minimally disruptive alteration in the radiology order entry system can encourage direct physician involvement, and improve patient care by reducing the number of low-yield examinations," Vartanians said in a statement.

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