Myocardial perfusion imaging determination using an appropriate use smartphone application.

Area of Science:

• Cardiology
• Medical Imaging
• Health Informatics

Background:

• Inappropriate cardiac imaging leads to significant healthcare costs.
• Unnecessary imaging increases patient radiation exposure.
• Standardizing imaging use is crucial for cost-effectiveness and patient safety.

Purpose of the Study:

• To evaluate the feasibility of a smartphone application for assessing the appropriateness of cardiac radionuclide imaging orders.
• To determine if a mobile tool can be used at the point of order to guide appropriate test selection.
• To leverage the 2009 Appropriate Use Criteria (AUC) for Cardiac Radionuclide Imaging.

Main Methods:

• A smartphone application based on the 2009 AUC was used to evaluate 403 stress myocardial perfusion imaging (MPI) orders.
• The app classified each MPI order as Appropriate, Inappropriate, or Uncertain.
• The time required to use the app and the characteristics of the ordering physicians were recorded.

Main Results:

• Out of 403 stress MPIs, 66.25% were Appropriate, 29.28% Inappropriate, and 3.23% Uncertain.
• The average time to assess appropriateness using the app was 44 seconds.
• Inappropriate MPI orders were more common among non-teaching physicians and in female patients.

Conclusions:

• A free smartphone app effectively assists physicians in determining the appropriateness of stress MPI orders.
• The app is a time- and cost-effective tool for point-of-order decision support.
• This mobile application has the potential to improve adherence to AUC, reduce healthcare costs, and minimize radiation burden.