EHR-based solutions to the iodinated contrast shortage reduce usage by 12%

Since the onset of the contrast media shortage, countless mitigation strategies have been shared, but recently experts highlighted an alternative preservation tactic that is frequently overlooked, though very effective. 

This week in the American Journal of Roentgenology, experts from a large, multisite health system detailed their efforts to preserve contrast supplies by implementing electronic health record (EHR) order entry-based interventions. This consisted of creating a pop-up sidebar within the EHR that would appear any time a provider requested a contrast-enhanced study. The alerts cautioned providers about the shortage while also suggesting alternative imaging modalities. 

The intervention went into effect at the health system on May 10, before being adjusted to require ordering providers to enter detailed clinical information for each requisition on May 16. Radiologists would then use the information provided to protocol the requested exams.  

To determine the effectiveness of the interventions, experts analyzed the records of 78,792 patients who underwent CT scans before and during implementation between April 1 and July 3, 2022. 

Through this, the experts observed a 12% reduction in the number of patients who underwent contrast-enhanced imaging per day, in addition to a 15.2% drop in the number of contrast-enhanced exams ordered per day. 

“The findings indicate the ability to rapidly achieve changes in ordering clinician behavior and subsequent clinical practice using system-wide EHR changes,” first author Daniel I. Glazer, MD, of the Center for Evidence-Based Imaging at Brigham and Women’s Hospital in Boston, and colleagues wrote. 

The detailed analysis can be viewed here

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