Optimizing Radiologist e-Prescribing of CT Oral Contrast Agent Using a Protocoling Portal

• Published in: American journal of roentgenology (1976) Vol. 201; no. 6; pp. 1298 - 1302
• Main Authors: Wasser, Elliot J., Galante, Nicholas J., Andriole, Katherine P., Farkas, Cameron, Khorasani, Ramin
• Format: Journal Article
• Language: English
• Published: United States 01.12.2013
• Subjects: Administration, Oral; Contrast Media - administration & dosage; Electronic Prescribing; Humans; Medical Order Entry Systems; Practice Patterns, Physicians' - statistics & numerical data; Prospective Studies; Radiography, Abdominal; Time Factors; Tomography, X-Ray Computed
• ISSN: 0361-803X; 1546-3141; 1546-3141
• DOI: 10.2214/AJR.12.9982

The purpose of this study is to quantify the time expenditure associated with radiologist ordering of CT oral contrast media when using an integrated protocoling portal and to determine radiologists' perceptions of the ordering process. This prospective study was performed at a large academic tertiary care facility. Detailed timing information for CT inpatient oral contrast orders placed via the computerized physician order entry (CPOE) system was gathered over a 14-day period. Analyses evaluated the amount of physician time required for each component of the ordering process. Radiologists' perceptions of the ordering process were assessed by survey. Descriptive statistics and chi-square analysis were performed. A total of 96 oral contrast agent orders were placed by 13 radiologists during the study period. The average time necessary to create a protocol for each case was 40.4 seconds (average range by subject, 20.0-130.0 seconds; SD, 37.1 seconds), and the average total time to create and sign each contrast agent order was 27.2 seconds (range, 10.0-50.0 seconds; SD, 22.4 seconds). Overall, 52.5% (21/40) of survey respondents indicated that radiologist entry of oral contrast agent orders improved patient safety. A minority of respondents (15% [6/40]) indicated that contrast agent order entry was either very or extremely disruptive to workflow. Radiologist e-prescribing of CT oral contrast agents using CPOE can be embedded in a protocol workflow. Integration of health IT tools can help to optimize user acceptance and adoption.