More Clinical Info on CT Requisitions Improves Interpretation

Quality of radiologic interpretation and billing efficiency improve when clinicians are aware of the importance of adding clinical information to requisitions, according to a study published in the American Journal of Roentengenology.

Researchers from the University of Chicago Medical Center in Illinois performed a prospective study to determine if the quality of head CT findings would change with the addition of an intervention teaching emergency department (ED) staff about the importance of adding clinical information on head CT requisitions.

Attending neuroradiologists evaluated 1,100 randomly selected ED requisitions for unenhanced head CT, grading them for clinical and billing adequacy on a scale of 0 to 2. After the first 400 studies, ED staff was provided with the educational intervention. A reminder slide was placed on a large screen in the ED staff working area with examples of appropriate history. Postintervention data (700 studies) were subsequently obtained. Mean scores and payment lag time before versus after the intervention were compared by Wilcoxon rank sum test.

Results showed a statistically improvement in mean scores after the intervention for both clinical and billing adequacy categories:

• Clinical scores increased from 1.32 to 1.43.
• Billing scores increased from 1.64 to 1.74.
• Payment lag time decreased from 75.8 days to 54.7 days.

According to the researchers, the percentage of studies with a score of 2 increased in both categories, and the percentages of 0 and 1 scores declined.

The researchers concluded that the quality of clinical information provided on imaging requisitions by ED faculty and residents, as well as billing efficiency and payment lag time improved after this educational intervention.