Diagnostic imaging requisition quality when using an electronic medical record: a before-after study

Diagnostic imaging requisition (DIR) content is legally constrained for care quality and patient safety concerns. A French national indicator, based on administrative and clinical data, has been introduced to monitor nationwide the conformity of such documents (CDIR). The purpose of this study was to assess the effect on CDIR of the deployment of the ORBIS™ electronic medical record at the Tenon hospital (Paris, France). A before-after study has been carried out. A significant increase of CDIR, from 37.0% (n=676) to 49.1% (n=800), was observed (p < 10⁻⁵). Conformity of administrative criteria improved, but there was no statistical difference of clinical criteria conformity, despite the improvement of clinical history documentation (100%). Up to five different paper-based requisition forms were used by clinical departments in the before period. In the after period, only 27.1% of requisitions were ORBIS-edited with a CDIR of 66.8% (n=217). In both periods, CDIR was correlated to the level of standardization of the forms.