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Clinical decision support for high-cost imaging: A randomized clinical trial

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  • Joseph Doyle
  • Sarah Abraham
  • Laura Feeney
  • Sarah Reimer
  • Amy Finkelstein

Abstract

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.

Suggested Citation

  • Joseph Doyle & Sarah Abraham & Laura Feeney & Sarah Reimer & Amy Finkelstein, 2019. "Clinical decision support for high-cost imaging: A randomized clinical trial," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-13, March.
    • Handle: RePEc:plo:pone00:0213373
    DOI: 10.1371/journal.pone.0213373
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    Cited by:

    1. Madhu Mazumdar & Jashvant V. Poeran & Bart S. Ferket & Nicole Zubizarreta & Parul Agarwal & Ksenia Gorbenko & Catherine K. Craven & Xiaobo (Tony) Zhong & Alan J. Moskowitz & Annetine C. Gelijns & Davi, 2021. "Developing an Institute for Health Care Delivery Science: successes, challenges, and solutions in the first five years," Health Care Management Science, Springer, vol. 24(1), pages 234-243, March.
    2. Ari Bronsoler & Joseph Doyle & John Van Reenen, 2021. "The impact of healthcare IT on clinical quality, productivity and workers," CEP Discussion Papers dp1801, Centre for Economic Performance, LSE.
    3. Ari Bronsoler & John Van Reenen & Joseph Doyle, 2022. "The Impact of Health Information and Communication Technology on Clinical Quality, Productivity, and Workers," Annual Review of Economics, Annual Reviews, vol. 14(1), pages 23-46, August.

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