Imaging & Evidence

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 - Lisa Fratt - Portrait
Lisa Fratt, Editor

March roared in like a lion in the imaging community. Research published in the March issue of Health Affairs determined the ability to view imaging results electronically correlated with more orders for diagnostic imaging.

Danny McCormick, MD, MPH, director at the Cambridge Health Alliance in Cambridge, Mass., and colleagues reviewed 28,741 patient visits to 1,187 providers and linked the computerized availability of imaging results in an EHR or other device with a 40 to 70 percent greater likelihood an imaging test would be ordered.

The findings ignited a firestorm among imaging and informatics stakeholders. National Coordinator for Health IT Farzad Mostashari, MD, blasted the results in his weekly Health IT Buzz blog, pointing out the 2008 data preceded the meaningful use era and emphasizing that the study did not consider decision support or electronic information exchange.

This recent study seems to contradict a study published March 2011 in Health Affairs, which reported 92 percent of studies on health IT found overall positive results in improving efficiency, reducing unnecessary tests and improving the quality of care. True, and yet, other studies underscore the need for consistent application of evidence in imaging, i.e. decision support.

A study published in the April issue of The American Journal of Medicine found highly variable use of head CT among emergency physicians, even those from the same hospital.

A study published in Annals of Internal Medicine March 12 adds fuel to the fire. Carrie N. Klabunde, PhD, of the National Cancer Institute, and colleagues surveyed 962 U.S. primary care physicians and found they frequently order lung cancer screening tests for asymptomatic patients even though major expert groups do not recommend it.

The Office of the National Coordinator for Health IT (ONC) seems to be setting the stage for appropriate use. The inclusion of radiology in computerized physician order entry, image accessibility through the EHR and image exchange among facilities are among the 125 potential measures under consideration for meaningful use Stage 2.

For more on the topic, read “Meaningful Use and Radiology: Can a Square Peg Fit in a Round Hole?” in this issue.

As the drive for evidence-based medicine accelerates, radiology can play a key role. However, it promises to be a rocky road and successful navigation requires knowledge, leadership and vision. Please leverage Health Imaging and its daily news updates at healthimaging.com as resources, and let us know how we can better meet your needs.