Imaging Information Systems
A 2003 survey of more than 1,000 Americans by Opinion Research Corporation found that 67 percent believed that patients sometimes or always undergo unnecessary imaging tests, such as MRI, CT scans, and X-ray.1 But new imaging information systems that blend clinical knowledge with computer power may change that view.
Health care providers are beginning to use clinical information systems that integrate databases of imaging files, treatment data, and outcomes and are making them available to physicians electronically. Physicians can obtain instant information on which imaging tests are most appropriate for an individual patient's symptoms.
- At Brigham and Women's Hospital in Boston, physicians ordering an imaging test can compare their patient's symptoms with information from thousands of individual patient histories. Plus, they can learn about the experiences of physicians with similar cases, information from medical journals, and any recommended practice guidelines.
- The physician enters the patient's symptoms into a web-based application, the system compares the symptoms against its database, and offers the physician advice about which test would be appropriate. The physician can then use the information to make his or her own decision. Once the test is completed, the results are made available electronically to the physician and included in the patient's electronic medical record. The data is then rolled into the information system for use by other physicians.
- Vanderbilt University Medical Center in Nashville operates a similar clinical information system that blends the experiences of physicians with the evidence from medical journals. When physicians ask for an imaging test – or they prescribe lab work or a medication – the system offers information on the latest standards of care and medical thinking.
- The system has significantly changed physician behavior. In the past, physicians routinely ordered chest X-rays for patients in intensive care every morning, regardless of whether their condition had improved. The excessive tests increased costs and exposure to unnecessary radiation. Vanderbilt decided to make the physicians give a good reason for each test. As a result, the X-rays dropped 30 percent, saving $1.1 million annually.2
1 "New System Delivers Critical Information in Real Time; Reduces Medical Errors, Costs," Associated Press Business Wire, February 11, 2003.
2 "Doctor's Orders: Computerized Decision-Support System Directs Vanderbilt Physicians to the Latest Treatment Data, Helping to Eliminate Unnecessary Costs," John Morrissey, Modern Healthcare, Vol. 32, p. 32, April 22, 2002.
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