There's an alternative to radiology benefit managers that can cut down on labor hours, save money, and ensure patients receive the right imaging test the first time. Yet clinical physician order entry with evidence-based decision support, sometimes called e-ordering, is being used in only a few places because healthcare plans are resistant to change, despite the proven benefits.

While there are computer physician order entry systems in circulation, most often associated with a RIS, the most interesting and important element of these systems is decision support, according to several experts. Decision support circumvents the need for radiology benefit managers by electronically obtaining prior authorization for an exam.

As Diagnostic Imaging previously reported, Massachusetts General Hospital was the first to create an order/support system. Staff at the hospital term their tool “radiology order entry and decision support” and they created the system mostly to enable electronic ordering of exams, but also to help the referring physicians figure out which exam to order in the first place (see “Hospital finds tough road to ROE worth the effort,” February 2007, page s-9).

WHAT THEY DO

The advantage of order/support systems is they help manage and automate complex workflows involving the ordering doctor, clinic staff, the patient, radiology scheduling personnel, technologists, radiology billing personnel, and, eventually, radiologists, said Dr. Chris Sistrom, vice chair of radiology at the University of Florida and visiting research fellow at MGH.

“This is especially true when there are preauthorization regimens from payers and increasing emphasis on compliance with various quality and fiscal requirements,” he said. “Adopting computerized order entry and fulfillment is a great opportunity for imaging providers to clean up and modernize their whole business operation.”