Prospective cost implications with a clinical decision support system for pediatric emergency head computed tomography
- 25.08.2021
- Original Article
Erschienen in:
- Verfasst von
- Shireen E. Hayatghaibi
- Marla B. K. Sammer
- Varsha Varghese
- Victor J. Seghers
- Andrew C. Sher
- Erschienen in
- Pediatric Radiology | Ausgabe 13/2021
Abstract
Background
Unnecessary imaging is a potential cost driver in the United States health care system.
Objective
Using a clinical decision support tool, we determined the percentage of low-utility non-contrast head computed tomography (CT) examinations on emergency patients and calculated the prospective cost implications of providing low-value imaging using time-driven activity-based costing at an academic quaternary pediatric hospital.
Materials and methods
A clinical decision support tool for imaging, CareSelect (National Decision Support Co., Madison, WI), was integrated in silent mode into the electronic health record from September 2018 through August 2019. Each non-contrast head CT order received a score from the clinical decision support tool based on the American College of Radiology Appropriateness Criteria. Descriptive statistics for all levels of appropriateness scores were compiled with an emphasis on low-utility exams. A micro-costing assessment was conducted using time-driven activity-based costing on head CT without contrast examinations.
Results
Within the 11-month time period, 3,186 head CT examinations without contrast were ordered for emergency center patients. Among these orders, 28% (896/3,186) were classified as low-utility studies. The base case CT pathway time was 43 min and base case total cost was $193.35. The base case opportunity cost of these low-utility exams extrapolated annually amounts to $188,902 for our institution.
Conclusion
Silent mode implementation of a clinical decision support tool resulted in 28% of head CT non-contrast exams on emergency patients being graded as low-utility studies. Prospective cost implications resulted in an annual base case cost of $188,902 to Texas Children’s Hospital.
Anzeige
- Titel
- Prospective cost implications with a clinical decision support system for pediatric emergency head computed tomography
- Verfasst von
-
Shireen E. Hayatghaibi
Marla B. K. Sammer
Varsha Varghese
Victor J. Seghers
Andrew C. Sher
- Publikationsdatum
- 25.08.2021
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Pediatric Radiology / Ausgabe 13/2021
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998 - DOI
- https://doi.org/10.1007/s00247-021-05159-9
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
