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Study: EHR In ED Crucial For Radiological Decisions

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John L. Ulmer, MD, doesn’t mince words when he discusses the implications of a new study about radiology and electronic health records that was published in this month’s issue of Health Affairs:

In my mind, it would be below the standard of care to practice radiology and to interpret imaging studies without access to the EHR.

Dr. Ulmer is professor of radiology and director of neuroradiology research at the Medical College of Wisconsin in Milwaukee. He’s also senior author of the study. He was quoted by DOTmed News.

The study involved 2,000 head CT scans that had been ordered by emergency department physicians at Froedtert Hospital in Milwaukee. Three neuroradiologists with clinical experience of 2, 16, and 31 years looked at the medical information entered by emergency physicians and compared it to any additional information retrieved from EHR by the interpreting radiologist.

In 6.1 percent of the cases, at least two of the three neuroradiologists agreed that the extra EHR information “very likely” affected image interpretations in a way that influenced the treatment of the head CT patients. In 16 percent of the cases, at least two of the three radiologists agreed that EHR data “possibly” changed interpretation and treatment. The most experienced neuroradiologist “had the greatest sensitivity to the clinical history,” the Health Affairs article says.

According to the article, “Additional information gleaned from the EHR that was rated as very likely to affect medical care included cancer history, treatment history, elevated risk of hemorrhage, symptoms of infection, immunocompetency, immigrant status, pregnancy status, metabolic derangements, and laboratory values.”

Dr. Ulmer said the study indicates the importance of EHR implementation. “What we hope will happen,” he said, “is that health care providers will recognize, on a more wide-scale basis, the value of implementing the EHR and the potential harm that may come from absence of EHR access.”

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