Clinical decision support for high-cost imaging: A randomized clinical trial.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
18
09
2018
accepted:
09
02
2019
entrez:
16
3
2019
pubmed:
16
3
2019
medline:
18
12
2019
Statut:
epublish
Résumé
There is widespread concern over the health risks and healthcare costs from potentially inappropriate high-cost imaging. As a result, the Centers for Medicare and Medicaid Services (CMS) will soon require high-cost imaging orders to be accompanied by Clinical Decision Support (CDS): software that provides appropriateness information at the time orders are placed via a best practice alert for targeted (i.e. likely inappropriate) imaging orders, although the impacts of CDS in this context are unclear. In this randomized trial of 3,511 healthcare providers at Aurora Health Care, we study the impacts of CDS on the ordering behavior of providers. We find that CDS reduced targeted imaging orders by a statistically significant 6%, however there was no statistically significant change in the total number of high-cost scans or of low-cost scans. The results suggest that the impending CMS mandate requiring healthcare systems to adopt CDS may modestly increase the appropriateness of high-cost imaging.
Identifiants
pubmed: 30875381
doi: 10.1371/journal.pone.0213373
pii: PONE-D-18-26751
pmc: PMC6419998
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0213373Déclaration de conflit d'intérêts
I have read the journal’s policy and the authors of this manuscript have the following competing interest: Dr. Sarah Reimer is an employee of Aurora Health and was blinded from interim results. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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