Appropriateness of advanced diagnostic imaging ordering before and after implementation of clinical decision support systems.

Appropriateness of AdvancedDiagnostic Imaging Ordering Before andAfter Implementation of Clinical Decision Support Systems Computerized clinical decision support (CDS) systems that match patient characteristics against appropriateness criteria to produce algorithmic treatment recommendations are a potentialmeansof improving care.1,2 TheProtectingAccess to Medicare Act of 2014mandates use of CDS systems for the ordering of advanced diagnostic imaging in the Medicare program starting in 2017.3 Inadescriptiveobservational study,weuseddata fromthe Medicare Imaging Demonstration to evaluate the relationship of CDS systemusewith the proportion of imaging orders matched toappropriateness criteria, theappropriatenessofordered images, and the proportion of orders changed following feedback.