Tarik K. Alkasab MD, Presenter: Nothing to Disclose

Jeannette Ryan Alkasab, Abstract Co-Author: Nothing to Disclose

Hani H. Abujudeh MD, MBA, Abstract Co-Author: Nothing to Disclose

Though computerized provider order entry (CPOE) systems are increasingly being implemented to increase efficiency, their effect on the information provided to radiologists by ordering physicians is unclear. By comparing requisitions for abdominal CT scans in our emergency department (ED) before and after implementation of a CPOE system, we assess differences in the provided information.

Consecutive requisitions for abdominal CT scans in the MGH ED were reviewed from two ten-day periods before and after CPOE implementation. The provided clinical history of each requisition was rated on a three-level scale ("none", "some", or "detailed" information) for the level of detail provided for four categories: signs/symptoms; medical history; abnormal test results; and clinical question. Differences between CPOE and handwritten requisitions in the detail provided in each category were then assayed using a χ2 test.

Clinical histories were examined for 135 CPOE-generated requisitions and 141 handwritten requisitions. Significant differences between the groups were found in the provided clinical questions and the prior medical histories. A detailed clinical question was asked in 3 of the handwritten and 25 of the CPOE requisitions; some question was found in 46 requisitions from each group (p<0.0001). A detailed medical history was given in 14 of the handwritten and 16 of the CPOE requisitions; some prior history was present on 58 and 80 histories, respectively (p=0.0027). Detailed signs/symptoms were given in 57 of the handwritten and 36 of the CPOE requisitions; some data were on 65 and 68 from each group (p=0.0805). Detailed abnormal results were described in 3 of the handwritten and 4 of the CPOE requisitions; some results were given on 21 and 14 requisitions, respectively (p=0.4933).

Using a CPOE system, ED providers tend to give more detail on medical history and on the clinical question when ordering abdominal CT scans. Since these data are especially helpful in interpreting ED studies, we conclude that the CPOE system has improved provider-radiologist communication.

CPOE systems can increase the quality of clinical histories provided to ED radiologists.

Alkasab, T, Ryan Alkasab, J, Abujudeh, H, Effects of a Computerized Provider Order Entry System on Clinical Histories Provided in Emergency Department Radiology Requisitions.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5014835.html