Clinical decision support tools for order entry

Abstract

Medical imaging has helped to transform healthcare and will continue to advance the understanding and treatment of disease. Despite the substantial benefits of medical imaging, there is wide variation in the use of imaging (especially high-cost imaging) and concern about it’s inappropriate use persists. Inappropriate use may result in suboptimal quality of care and wasteand may harm patients by exposure to unnecessary ionizing radiation, the risks of over-diagnosis and over-treatment, including unnecessary additional tests and treatments provided in follow-up of incidental or ambiguous imaging findings. Clinical decision support tools for order entry provide an opportunity to embed evidence/ clinical best practices in the workflow of providers requesting imaging examinations to reduce inappropriate use of imaging. In this chapter, we define clinical decision support for order entry, review trends in imaging use and describe general features of effective clinical decision support including experience from large-scale implementations. We conclude by reviewing some of the emerging challenges and opportunities for imaging clinical decision support and future directions.