Australian researchers have come up with an iPad application that can help clinicians take the right decision on diagnostic imaging.
The application DiPHD could be useful in a wide range of clinical scenarios and has been developed at the University of Western Australia's Centre for Software Practice (CSP). The Department of Imaging Services at the Royal Perth Hospital collaborated with the CSP in the research.
Inappropriate imaging has a number of potential adverse outcomes. Unnecessary or excessive examinations may expose patients to risk without benefit, including the risk of false-positive results. On the other hand, failure to provide the most appropriate examination may result in inefficient diagnosis and ineffective treatment. From the perspective of 'accountability', inappropriate services are a threat to the effective allocation of resources to health care.
A significant threat to appropriate imaging is lack of knowledge. The task of keeping up-to-date with developments in clinical practice is increasingly difficult, due to expanding research activity and publications, clinical specialisation and sub-specialisation and new applications of technology. It is difficult to acquire and maintain the necessary breadth and depth of knowledge for confident and correct decision-making. A 'medical knowledge crisis' is well recognised, as is the need for improved knowledge management and electronic decision support systems in the health sector. The development of decision support systems has been suggested as a specific strategy to increase the appropriateness of diagnostic testing.
It is in such a backdrop the Diagnostic Imaging Pathways, an initiative of the West Australian government, gains significance. It includes more than 130 pathways covering all the major organ systems and common clinical scenarios. The pathways have been developed based on broad clinical consensus, and best-available evidence, and are under continuous review and development.
The principle clinical lead behind the Diagnostic Imaging Pathways, Professor Richard Mendelson, said the application will help doctors make the right decisions delivering the right treatment at the right place and the right time.
"Thirty per cent of imaging requests are incorrect or inappropriate - the iPad application DiPHD will help make sure that patients have the best chance of getting the most accurate diagnosis," Professor Mendelson said.
CSP Director Associate Professor David Glance said having the pathways available on a platform like the iPad ensures that doctors will be able to access vital information, literally at their fingertips.
"Imaging is the first step in future pathways that will also involve pathology and clinical referral guidelines," Associate Professor Glance said.