[story continued: Clinician “Hands-on” Ordering Reduces Unnecessary Exams]

Massachusetts General Hospital’s decision support system provides a yield score based on clinical information provided in support of the exam request. Scores of 1 to 3 indicate low-yield, 4 to 6 marginal, and 7 to 9 indicated exam. MGH’s system has been expanded so that scores assigned to particular exams have been modified and adapted according to continuous feedback from practicing clinicians and radiologists. Prior to the rule change, the fraction of exams that were scheduled through the order entry system with a low-yield decision support score was relatively unchanged -- between 3.5% and 5% on a quarterly basis.
     After the policy change was put into place, the proportion of total exam requests by physicians directly logging into the system more than doubled, from 26.31% of 42,737 requests to 54.37% of 76,238 exams requested. The percentage of low-yield exams requested decreased from 5.4% of 38,801 to 1.9 % of total of 65,765 total requests. There was relatively no change in the rate of completion of exam requests not affected by the policy change. (HealthImaging.com, 5/25/10)