HHE Radiology and imaging supplement 2018 | Page 6
workload and yet to provide the greatest possible
value to the patients.
Contribution of a radiologist to a correct and
timely imaging report is key for the right
treatment decision. In our opinion, the first step
toward creating value for patients referred to the
radiology department starts with assuring the
appropriateness of the imaging examinations.
There are statistics showing that up to 20% of all
requests in Europe and up to 50% in the USA are
not appropriate. 2,3 In this regard, the radiologist
should play a pivotal role in providing the right
examination for the right clinical indications,
and, if necessary, to reject unnecessary or
redundant imaging requests. The reality, however,
is somewhat complex. In many situations,
especially in the case of outpatients, the
information coming with the request for the
radiological examination is minimal. A promising
technical support could be provided by the
clinical decision support (CDS) systems, which
ensure whether the modality requested to the
examination and patient condition is in line with
currently valid guidelines. CDS systems prove,
whether MRI or CT, with or without contrast
agent, is the most appropriate imaging modality
to answer the given clinical question. Preferably,
these systems should be fed with additional
information from the electronic health record
(EHR) of the patient (for example, renal function,
pregnancy, HIV status, diabetes). Beyond choosing
the right modality, an intelligent CDS system
should even be able to assign the appropriate
protocol, e