Clinical Decision Support (CDS) systems are used to make imaging referral guidelines available and usable at the point of care. By providing information to referring physicians on the appropriateness of different modalities for a given clinical indication, CDS supports them in referring.
In Europe, imaging referral guidelines exist in all member states as mandated by the Euratom BSS directive. However, awareness of guidelines is limited while the use of guidelines is minimal, according to an ESR-led study funded by the European Commission (2013). To address this situation, the ESR started the ESR iGuide initiative.
CDS is a proven way to increase the use of guidelines and thereby improve appropriateness in medical imaging. CDS systems are most effective when implemented within existing workflows through integration into electronic medical records or CPOE (Computerised Physician Order Entry) systems.
The adoption of CDS in the United States, where ACR Select has been available since 2012, is widespread and has been driven by healthcare legislation mandating the use of accredited CDS systems for imaging referrals from January 1, 2019. Studies have shown that CDS significantly reduces the number of inappropriate imaging exams.
Since 2016, pilot projects have started in Europe to introduce ESR iGuide in various countries. Initial results from Croatia demonstrate that the use of CDS can improve the? rate of appropriate referrals from 75 percent to almost 80 percent. At the Hospital Clinic Barcelona, imaging referrals were deemed appropriate 89 percent of the time following the introduction of CDS. The statistics and analysis capabilities that CDS systems provide offer important insights for improving clinical practice and further improving the?adherence to evidence-based guidelines.
Learning objectives
To become familiar with EuroSafe Imaging and how to engage;
To understand how clinical decision support works;
To learn more about imaging referral guidelines in Europe;
To learn more about the educational benefits of embedding guidelines in the clinical workflow;
To understand the benefits for implementing CDS for radiologists, referrers and patients.
