Electronic decision support for diagnostic imaging in a primary care setting

J Am Med Inform Assoc. 2011 May 1;18(3):267-70. doi: 10.1136/amiajnl-2011-000049.


Methods: Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines.

Results: Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software.

Conclusions: Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care Information Systems
  • Attitude to Computers
  • Decision Support Systems, Clinical* / statistics & numerical data
  • Diagnostic Imaging / statistics & numerical data*
  • Family Practice
  • Guideline Adherence*
  • Humans
  • Manitoba
  • Medical Order Entry Systems*
  • Practice Patterns, Physicians'
  • Rural Health Services
  • Unnecessary Procedures*
  • User-Computer Interface