Electronic transfer of radiology requests and reports with decision support

Objective: To develop a secure electronic system for transporting radiology requests and reports coupled with an electronic decision support tool to assist general practitioners with appropriate selection of radiology investigations. Anticipated benefits of the system include increased evidence-based practice, improved patient appointment scheduling and ultimately better patient care. Setting: The system was trialed by a single general practice and a radiology department located in a rural area of Australia. Methods: A secure e-mail system, known as Argus was developed to transport the electronic radiology requests and reports. The system is based on Health Level 7 (HL7) messaging standards. The electronic request forms were prepared by working with the vendor of Medical Director (a widely used GP desktop software package) to modify their radiology request function. This maximised efficiency and minimised data errors as the system automatically imports patient data from the existing GP patient electronic record into the request form. A standard decision support framework was utilised for the decision support tool. The module developed was for lower back pain and was based on guidelines from the Royal Australasian College of Radiologists. Results: Successful transmission of radiology requests and results was achieved. Over 150 requests were sent during the trial, with the project demonstrating the ability to provide timely, accurate, secure information flow with guaranteed delivery between a general practice and a radiology department in a rural health setting. The decision support module was also implemented and successfully utilised. Conclusion: The project has achieved a first for Australia in that it successfully transmitted electronic radiology requests from a local GP practice to the local radiology department using Public Key Infrastructure (PKI) encryption and HL7 messaging. The system successfully incorporated a decision support module for lower back pain and it is now planned to extend this decision support to incorporate other medical conditions. © The Journal on Information Technology in Healthcare.C