The use of a fully integrated electronic medical record to minimize cumulative lifetime radiation exposure from CT scanning to detect urinary tract calculi.
In order to determine the effects of implementation of an electronic medical record on rates of repeat computed tomography (CT) scanning in the emergency department (ED) setting, we analyzed the utilization of CT of the kidneys, ureters, and bladder (CT KUB) for the detection of urinary tract calculi for periods before and after the implementation of a hospital-wide electronic medical record system. Rates of repeat CT scanning within a 6-month period of previous scan were determined pre- and post-implementation and compared. Prior to implementation, there was a 6-month repeat rate of 6.2 % compared with the post-implementation period, which was associated with a 6-month repeat rate of 4.1 %. Statistical analysis using a two-sample, one-tailed t test for difference of means was associated with a p value of 0.00007. This indicates that the implementation of the electronic medical record system was associated with a 34 % decrease in 6-month repeat CT KUB scans. We conclude that the use of an electronic medical record can be associated with a decrease in utilization of unnecessary repeat CT imaging, leading to decreased cumulative lifetime risk for cancer in these patients and more efficient utilization of ED and radiologic resources.
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA, USA. sckohler@gmail.com
Steven W
SW
Kohler
Richard
R
Chen
Alex
A
Kagan
Dustin W
DW
Helvey
David
D
Buccigrossi
D057286:Electronic Health Records; D004636:Emergency Service, Hospital; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014513:Ureter / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014545:Urinary Calculi / Q000000981:diagnostic imaging*