Tool cuts down on ER CT scan exposure

A new electronic medical record tool cuts down on unnecessary CT scans in U.S. hospital emergency patients with abdominal pain, researchers say. Dr. Angela M. Mills, medical director of the emergency department at the Hospital of the University of Pennsylvania, said abdominal pain was the most common reason why people seek care in U.S. emergency rooms, but the symptoms may be caused by myriad problems -- simple tummy distress to a life-threatening ectopic pregnancy. Emergency physicians tend to lean heavily on tests like CT scans, even though they expose patients to radiation. Fourteen percent of emergency room patients get scanned, contributing to ballooning healthcare costs. The researchers investigated a new tool embedded within patients' electronic medical records that walked physicians through a series of questions that served as checks and balances for their decision to order a CT scan to investigate a patient's abdominal pain. The doctors were queried on what diagnosis they were looking for, from appendicitis to colitis to an ovarian cyst or tumor, and how likely they thought it that a patient had that problem. If a medical resident ordered the test, it had to be approved by an attending physician before the patient could receive the scan. Those steps, the researchers said, appeared to play a role in prompting the care team to rethink their choice of tests. The findings were presented at the annual meeting of the Society for Academic Emergency Medicine in Chicago.