Using Default Options to Decrease Unnecessary Imaging for Palliative Cancer Patients Receiving Radiation Therapy
There are several ways to align cancer patients so that radiation therapy is focused on the cancer target. CT scans are one method but national guidelines often recommend that this is not appropriate for palliative cancer patients. We found that nearly 80% of these types of patients were getting daily CT scans when guidelines recommended they should be getting none. This contributed to thousands of unnecessary CT scans per year.
We worked with the radiation oncology group to evaluate the decision-making process. We then changed the default in the electronic health record from daily CT scans to no CT scans. We randomly selected one site to implement the change and then subsequently implemented at the next site in a step-wedge fashion.
The clinical trial was implemented in 2017 and we will be evaluating the findings.