Embedded Decision Support Key to PACS Success

Radiology decision support tools are a bit like sunscreen – they can keep you from getting burned, but only if you bother to use them. That’s the conclusion of a new study in the July issue of the Journal of the American College of Radiology.

Researchers led by Matthew B. Morgan, MD, MS, wanted to know how much difference the integration – and therefore more convenient access for busy doctors – of decision support systms with picture archiving and communication systems (PACS) makes. Most decision support systems require radiologists to exit the PACS environment, which may deter busy clinicians from using it decision support.

Forty-eight radiology residents were randomly assigned to one of two groups: the control group had access to a radiology clinical decision support tool via standard Web browser access, which required manual login. The experimental group was provided access to the same tool through a one-click launch from within PACS with an automated login. Halfway through the 10-month study period, the groups were switched.

Results showed that the experimental (integrated) group used decision support three times more than the control group. When integrated access was removed from the experimental group, their use fell by 52 percent. When integrated access was granted to the control group, their use rose by 20 percent.

Although both methods of decision support showed increases in usage over the first five months of the study, the results confirmed a strong association between integration and use, Morgan said.

“Decision support tools that are embedded into the clinical workflow have the best chance of improving quality of care,” he said. “Embedding decision support tools into the workflow is an effective way to increase usage. While this may seem intuitive, not enough is done by PACS vendors and radiology IT groups in this regard.”