Electronic Health Record Order Entry-Based Interventions in Response to a Global Iodinated Contrast Media Shortage: Impact on Contrast-Enhanced CT Utilization.

Radiology informatics systems and clinical decision support tools in the electronic health record (EHR) can be leveraged to help impact ordering patterns in response to the ongoing global iodinated contrast media shortage. To assess the impact of EHR order entry-based interventions, implemented as part of a health system's response to the global contrast media shortage, on contrast-enhanced CT utilization. This retrospective study included 78,792 patients who underwent CT at a large multisite health system between April 1, 2022 and July 3, 2022. Two EHR-based interventions were imple-mented as part of the health system's response to the global contrast media shortage. A first EHR-based intervention on May 10, 2022 entailed creating an alert that appeared in a sidebar after any contrast-enhanced body CT orders, indicating the present shortage and recommending alternate imaging modalities. A second EHR-based intervention on May 16, 2022 required referrers to enter detailed clinical information for all contrast-enhanced body CT orders, which radiologists used when protocoling examinations. Data regarding CT orders and examinations performed were ex-tracted from the electronic data warehouse. During the pre-intervention, first post-intervention, and second post-intervention periods, the mean number of patients who underwent contrast-enhanced CT per weekday was 726, 689, and 639, respectively (p for pre-intervention vs second post-intervention periods, <.001). During the three periods, the mean number of patients who underwent CT per weekday was 1350, 1323, and 1314, respectively (p<.001). During the three periods, the mean number of patients who un-derwent contrast-enhanced body CT per weekday was 561, 531, and 491, respectively (p<.001). During the three periods, the mean number of orders for CT with IV contrast media per weekday was 154, 143, and 131, respectively (p<.001). During the three periods, the mean number of or-ders for CT without IV contrast media per weekday was 196, 202, and 221, respectively (p<.001). EHR order entry-based interventions implemented in response to the global contrast media shortage significantly reduced contrast-enhanced CT utilization within a large health system. The findings indicate the ability to rapidly achieve changes in ordering clinician behavior and subsequent clinical practice using system-wide EHR changes.