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2015 AEM Consensus Conference – Proposed Research Questions - April 23, 2015
Group 5: Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department: A
Research Agenda
Question 1: What determinants (barriers and facilitators) influence emergency physicians’ use of
evidence-based interventions (EBIs) when ordering imaging in the ED?
a) To what extent do the following potential barriers affect EBI use for ED imaging?
-Lack of knowledge of the EBI
-Lack of belief in effectiveness of the EBI
-Fear of missing a significant diagnosis
-Fear of litigation for missed/delayed diagnosis
-Financial incentive to order imaging
b) To what extent do the following potential facilitators affect EBI use for ED imaging?
-Educational interventions
-Financial incentive to safely reduce imaging
-Audit and feedback of clinician ordering rates/EBI use
Question 2: What implementation strategies at the institutional level can improve the use of EBIs for ED
imaging?
a) Which dissemination and implementation framework can best be applied to ED-based EBIs?
b) Which implementation strategies can increase the use of clinical decision instruments for
diagnostic imaging?
c) Which implementation strategies can increase the use of evidence-based guidelines for
diagnostic imaging?
Question 3: What interventions at the healthcare policy level can facilitate the adoption of EBIs for ED
imaging?
a) To what extent do quality measures impact the uptake of EBIs for ED imaging?
b) Does tort reform affect the use of EBIs in the ED?
c) Do evidence-based imaging guidelines developed by government agencies affect diagnostic
imaging rates?
d) Can health care legislation mandating use of EBIs change physician practice patterns?
Question 4: How can health information technology (HIT), including electronic health records, clinical
decision support, and health-information exchanges, be used to increase awareness, use and adherence
to EBIs for ED imaging?
a) What factors promote or inhibit use of HIT to guide ED imaging at the level of the individual
clinician, department, hospital, and healthcare system?
b) Can clinical decision support systems (CDSS) increase uptake of EBIs for ED imaging?
c) Can CDSS play in reducing cost and improving safety while also reducing risk to providers of
malpractice claims?