J Am Med Inform Assoc 18:267-270 doi:10.1136/amiajnl-2011-000049
  • Research and applications

Electronic decision support for diagnostic imaging in a primary care setting

  1. Martin H Reed2
  1. 1CurryCorp, Ottawa, Ontario, Canada
  2. 2Diagnostic Imaging, Health Sciences Centre, Children's Hospital, Winnipeg, Manitoba, Canada
  1. Correspondence to Dr Lynn Curry, 17 Oakland Avenue, Ottawa, Ontario K1S 2T1, Canada; lcurry1073{at}
  • Received 19 May 2010
  • Accepted 17 January 2011


Methods Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines.

Results Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software.

Conclusions Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow.


  • Funding This study was made possible through financial contributions from Health Canada and from the Canadian Association of Radiologists. The views expressed herein do not necessarily represent the views of either Health Canada or Canadian Association of Radiologists. Health Canada contract #: HC 6804-15-2008/9300006.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the University of Manitoba Research Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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