Appropriateness Projects

Significant change is coming to diagnostic imaging (DI) care. In Canada, and elsewhere, the change drivers are clear: mounting fiscal pressures, increasing concern with radiation safety and growing evidence of clinically ineffective use. These pressures will shape responses to a range of issues such as hybrid diagnostic imaging, personnel substitution and equipment replacement.

A solution in one area, that of appropriateness or clinical effectiveness of DI exam requests, could significantly impact not only clinically ineffective use but the other healthcare drivers as well.

CAR imaging referral guidelines have been available in booklet, PDF and CD formats and on physician websites. CAR recognized that for maximal effect, guidelines must be made seamlessly available as part of the clinician’s regular workflow. To achieve this, the CAR guidelines have been integrated into a computerized physician order entry (CPOE) system for diagnostic imaging with attendant computerized clinical decision support (CCDS). The CAR believes that this is the most effective way of implementing guidelines to ensure that DI resources are used most appropriately and effectively.

The CAR has tested the effectiveness of providing its Diagnostic Imaging Referral Guidelines through the computerized clinical decision support and CPOE.  Read the results below: