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Unnecessary diagnostic imaging (DI) examinations raise concerns for patient safety and place stress on human and financial resources. To reduce unnecessary DI examinations, several Canadian pilot studies have investigated how decision support systems (DSS) could be utilized. Based on interview results from our previous research, in addition to a literature review, themes emerged that influenced the features and design of a DI DSS prototype. Features include having the referring professional indicate how the results of the examination will be utilized (i.e. for diagnosis or patient management), increasing communication between referring physicians/nurse practitioners and radiologists, and displaying previous DI examinations (or orders that are scheduled to take place) to avoid duplicate orders. Presenting a patient's cumulative radiation exposure, and having resources for information support to guide physicians through challenging clinical decisions are two other features included in the DSS prototype. By incorporating physician perspectives and current literature into the design, this DSS aims to promote the appropriate use of DI resources by supporting physicians and nurse practitioners in their DI ordering practices.
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