The relationship between patient, radiologist, and primary care physician is critical when determining the best course of action for diagnostic imaging. Clinical Decision Support (CDS) systems can better facilitate the exchange of information in this relationship to ensure patients receive the test they need in the time they need it.
“We often imagine that most medical care occurs in hospitals when in actuality it occurs in primary care in the community,” says Dr. Cathy MacLean. “Family Physicians and NPs rely on radiology referrals every day in active practice.”
Dr. MacLean is a Professor and Faculty Development Director at the University of Saskatchewan, as well as a member of the CAR’s Imaging Referral Guidelines Working Group. She says that this relationship is imperative to patient care outcomes and can be maintained by continued communication and the mutual interest in ensuring best practices and wise stewardship of resources, which is where CDS systems can play an influential role.
“A CDS system can provide guidance in selecting the right diagnostic imaging test for the right reasons at the time of referral. Technology changes rapidly these days. Diagnostic imaging test preferences and recommendations can leapfrog and cause confusion. CDS systems can help family physicians by providing clear guidance on best practices that are grounded in research.”
Online CDS systems can provide easy access and guidance at the point of care. “This is a more efficient use of time for patient care and for physician education,” says Dr. MacLean. CDS systems can further reduce the laboriousness patients face by being tested. “Seeing multiple providers, going to facilities to get testing done, following up on tests with more tests – all of these things contribute to disease burden. CDS systems can help patients engage in conversations with their providers around the appropriateness of diagnostic imaging testing and timing.”
The Canadian healthcare system is currently facing the simultaneous challenges of diagnostic imaging backlogs and a global shortage of iodinated contrast media, the solutions to which are large, complex, and require time. CDS systems can relieve some of the pressure on diagnostic imaging at present. “With diagnostic imaging, there are potential risks of radiation exposure, and we want to protect patients by utilizing resources only when needed. An example might be understanding incidentalomas and the immense burden of follow up these create, which could be potentially managed more effectively with CDS e-referral systems.”
Overall, Dr. MacLean believes that maintaining a strong bond between patient, radiologist, and primary care physician is crucial for the viability of healthcare in Canada going forward, which comprehensive CDS systems can facilitate. Find out more about the CAR’s effort to implement CDS systems nationally.