Failure of Real-time Passive Notification about Radiation Exposure to Influence Physician Ordering Behavior

Area of Science:

• Medical Imaging
• Health Informatics
• Radiology

Background:

• Physician order entry systems are crucial for clinical decision-making.
• Managing patient radiation exposure is a growing concern in medical imaging.
• Real-time feedback mechanisms are being explored to influence physician behavior.

Purpose of the Study:

• To evaluate the impact of real-time, passive radiation exposure notifications on computed tomography (CT) scan orders.
• To assess if providing radiation dose information at the point of order influences physician decisions in the Emergency Department (ED).

Main Methods:

• A passive notification system was integrated into the computerized physician order entry (CPE) system.
• Notifications displayed estimated radiation dose in millisieverts (mSv), equivalent chest radiographs, and background radiation.
• CT scan ordering data was compared before and after the intervention in the ED.

Main Results:

• The CT scan rate was 14.9% before the intervention and 15.8% after.
• No statistically significant difference in CT scan orders was observed post-intervention.
• This held true for all chief complaints combined and for individual complaints.

Conclusions:

• Passive, real-time notification of patient radiation exposure via CPE systems does not significantly alter CT scan ordering in the ED.
• Further research may be needed to explore more effective strategies for radiation dose management.