Appropriateness of Advanced Diagnostic Imaging Ordering Before and After Implementation of Clinical Decision Support Systems

Published in: JAMA, The Journal of the American Medical Association, v. 313, no. 21, June 2, 2015, p. 2181-2182

Posted on RAND.org on July 13, 2015

by Peter S. Hussey, Justin W. Timbie, Lane F. Burgette, Neil S. Wenger, David J. Nyweide, Katherine L. Kahn

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Computerized clinical decision support (CDS) systems that match patient characteristics against appropriateness criteria to produce algorithmic treatment recommendations are a potential means of improving care. The Protecting Access to Medicare Act of 2014 mandates use of CDS systems for the ordering of advanced diagnostic imaging in the Medicare program starting in 2017. In a descriptive observational study, we used data from the Medicare Imaging Demonstration to evaluate the relationship of CDS system use with the proportion of imaging orders matched to appropriateness criteria, the appropriateness of ordered images, and the proportion of orders changed following feedback.

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