title: Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests.
abstract: OBJECTIVE
  The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department.
  
  
  METHODS
  This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study.
  
  
  RESULTS
  Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (p<.001). The time between emergency department admission and medical imaging did not vary between the two periods.
  
  
  CONCLUSIONS
  Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department.
authors.affiliation: Pôle Anesthésie Réanimation Douleur Urgences, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France; EA 2415, Clinical Research University Institute, Montpellier University, France. Electronic address: pierre.geraud.claret@gmail.com.
authors.forename: Pierre-Géraud
authors.initials: PG
authors.lastname: Claret
authors.affiliation: Pôle Anesthésie Réanimation Douleur Urgences, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: xavier.bobbia@gmail.com.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bobbia
authors.affiliation: Imagerie Médicale, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: francesco.macri@chu-nimes.fr.
authors.forename: Francesco
authors.initials: F
authors.lastname: Macri
authors.affiliation: Pôle Anesthésie Réanimation Douleur Urgences, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: stowell.andrew.34@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stowell
authors.affiliation: Pôle Anesthésie Réanimation Douleur Urgences, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: antho8422@hotmail.com.
authors.forename: Antony
authors.initials: A
authors.lastname: Motté
authors.affiliation: EA 2415, Clinical Research University Institute, Montpellier University, France; Département de Biostatistique Épidémiologie Santé Publique et d'Information Médicale, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: paul.landais@chu-nimes.fr.
authors.forename: Paul
authors.initials: P
authors.lastname: Landais
authors.affiliation: EA 2415, Clinical Research University Institute, Montpellier University, France; Imagerie Médicale, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: jean.paul.beregi@chu-nimes.fr.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Beregi
authors.affiliation: Pôle Anesthésie Réanimation Douleur Urgences, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nîmes, France. Electronic address: jean.emmanuel.delacoussaye@chu-nimes.fr.
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: de La Coussaye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020000:Decision Support Systems, Clinical; D003952:Diagnostic Imaging; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D050316:Medical Order Entry Systems; D008875:Middle Aged
keywords: Diagnostic imaging; Emergency service; Hospital; Medical order entry systems