August 3, 2022 – According to an open access article in the ARRS American Journal of Roentgenology (AJR)interventions based on electronic health record (EHR) order entry implemented in response to the global shortage of iodinated contrast media significantly reduced the utilization of contrast-enhanced CT in a large health system.
“The results indicate the ability to rapidly achieve changes in physician behavior and subsequent clinical practice through system-wide EHR changes,” wrote first author Daniel I. Glazer of the Center for Imaging-Based Evidence from Brigham and Women’s Hospital in Boston, MA. .
The retrospective study by Glazer and colleagues included 78,792 patients who underwent at least one CT scan (outpatient, inpatient, or emergency department) from April 1 to July 3 of 2022. On May 10, an initial EHR intervention created a sidebar alert after any contrast. -Improved body CT orders, noting the current iohexol shortage and recommending alternative imaging modalities. A second EHR-based intervention on May 16, 2022, required referrers to enter detailed clinical information for all contrast-enhanced body CT orders, which radiologists used to protocol the exams.
Ultimately, the mean number of patients undergoing contrast-enhanced CT per weekday during the preintervention, first postintervention, and second postintervention periods was 726, 689, and 639; the mean number of contrast-enhanced CT orders was 154, 143, and 131.
Noting that their health system spanned two large academic medical centers, seven community hospitals, three specialty hospitals, and several affiliated ambulatory care centers, all using a single EHR (Hyperspace, Epic Systems, Verona, WI): “the number of patients undergoing contrast – Enhanced CT exams per day decreased by 12.0% and the number of CT orders with contrast media decreased by 15.2% per day,” concluded the authors of this AJR article.
For more information: www.arrs.org
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