EHR screenshot showing sidebar text displayed to referring clinicians after placing orders for body CT (neck, chest, or abdomen and pelvis), describing iohexol shortage and providing appropriate strategies for iodinated contrast media conservation.
August 3, 2022 —According to an open-access article in ARRS’ American Journal of Roentgenology (AJR),electronic health record(EHR) order entry-based interventions implemented in response to the global iodinatedcontrast media shortagesignificantly reduced contrast-enhanced CT utilization within a large health system.
“The findings indicate the ability to rapidly achieve changes in ordering clinician behavior and subsequent clinical practice using system-wide EHR changes,” wrote first author Daniel I. Glazer of the Center for Evidence-Based Imaging at Brigham and Women’s Hospital in Boston, MA.
Glazer及其同事的回顾性研究纳入了从2022年4月1日至7月3日至少做过一次CT检查(门诊、住院或急诊)的78,792例患者。5月10日，一项初步的电子病历干预措施在任何对比增强体CT命令后创建了一个侧边栏警报，指出目前碘hexol短缺，并建议替代的成像方式。2022年5月16日，第二项基于ehr的干预措施要求转诊者输入所有对比增强全身CT命令的详细临床信息，放射科医生在处理检查时使用这些信息。
Ultimately, the mean number of patients undergoing contrast-enhanced CT per weekday during pre-intervention, first post-intervention, and second post-intervention periods was 726, 689, and 639; the mean number of contrast-enhanced CT orders was 154, 143, and 131.
Noting that their health system encompassed two large academic medical centers, seven community hospitals, three specialty hospitals, and multiple affiliated ambulatory care centers—all using a single EHR (Hyperspace, Epic Systems, Verona, WI)—“the number of patients undergoing contrast-enhanced CT examinations per day decreased by 12.0%, and the number of orders for CT with contrast media decreased by 15.2% per day,”the authors of this AJR article concluded.
For more information:www.arrs.org
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August 04, 2022
