Clinical decision support for high-cost imaging: A randomized clinical trial
Name
journal.pone.0213373.pdf
Description
Published version
Size
829.22 KB
Format
Adobe PDF
Checksum (MD5)
c55ca166e69358ee2c8062b95eee0ea0
Author(s)
Doyle, Joseph
Abraham, Sarah
Feeney, Laura
Reimer, Sarah
Finkelstein, Amy
Date Issued
2019
Journal
PLoS ONE
Publisher
Public Library of Science (PLoS)
Version
Final published version
Abstract
© 2019 Doyle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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.
MIT Department
Sloan School of Management
Massachusetts Institute of Technology. Department of Economics
Abdul Latif Jameel Poverty Action Lab (Massachusetts Institute of Technology)
Terms of Use
Creative Commons Attribution 4.0 International license
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DOI of Published Version
https://doi.org/10.1371/JOURNAL.PONE.0213373
