With special thanks to Dr. Kianda Mauch DNP, NP Adult/PHC, for her contribution.

In the fast-paced healthcare environment, efficiency and accuracy are crucial. Streamlining the requisition and ordering process for diagnostic imaging, particularly CT (Computed Tomography) and MRI (Magnetic Resonance Imaging), enhances patient care and operational efficiency. These imaging modalities are unique and specific to diagnoses. Currently, most facilities have their own referral and order forms specific to each test or procedure, leading to potential inefficiencies and errors.

Currently, healthcare providers often face challenges in locating and downloading specific forms tailored to each facility’s requirements, which consumes valuable time and effort. Additionally many of these forms are not available electronically, necessitating a paper-based completion process that involves scanning to charts and faxing. This process not only takes up practitioners' time but also occupies support staff, further straining resources.

Therefore, it was determined to be beneficial for all GoodX practitioners to have a single generic CT/MRI form that offers all options and includes the required patient information. This initiative, driven by practitioners using our EMR system, aimed to develop a standardised CT-MRI form.

To achieve this, we conducted a wide scale review of existing requisition and order forms across many healthcare facilities and researched best practice guidelines. By collaborating closely with GoodX practitioners, we gathered invaluable feedback to support the design of a universal requisition/order form that simplifies workflows, ensures accurate information capture, and reduces challenges in diagnostic imaging booking.

Why was this important?

The primary motivation behind this initiative was to minimise the time and effort required by the practitioner to accurately complete the requisition forms. Inadequate or incomplete information often leads to incorrect tests being ordered, necessitating follow-up calls that consume valuable time and resources. A comprehensive, standardised form can mitigate these issues, ensuring that all necessary information is captured upfront, thereby streamlining the process and enhancing overall efficiency.

Primary Goals

The primary goals of developing the generic CT-MRI form were:

1. Standardisation: Develop a single, standardised form that captures all necessary information for both CT and MRI procedures. This form is designed to be used across any licensed healthcare facility, including hospitals and Independent Health Facilities (IHFs).
2. Efficiency: Reduce the amount of time healthcare practitioners and administrative staff spend managing paper, verifying information, making follow-up calls, and ensuring the correct tests are ordered.
3. Comprehensiveness: Ensure the form captures all relevant patient information, clinical history, and specific requirements for the imaging procedures.

Key components of the form

The CT-MRI form was designed to include all essential information while being user-friendly.

• The introductory section visible upon receipt addresses aspects critical to scheduling administration such as the urgency of the procedure (urgent or routine), preferred language and interpreter needs, required infection prevention and control (IPAC) precautions, and the patient's mobility status.
• Patient information is meticulously captured, including full name, date of birth, gender, contact information, and insurance details. The safety checklist and clinical history section ensures comprehensive documentation of allergies (particularly to contrast media), recent renal function (creatinine levels), pregnancy status if applicable, presence of metal implants or foreign bodies (important for MRI safety), claustrophobia concerns, prior reactions to dye, and any additional relevant risk factors. A detailed clinical history section is also included to provide a complete history for the radiologist.
• The form specifies the type of exam requested, whether CT or MRI, along with any specific requirements such as with or without angiogram or arthrogram. It also identifies the specific area(s) to be scanned.
• Finally, the form includes information about the ordering practitioner, such as their name, contact number, email address, and the clinic or hospital name. Additionally, there is an option to list any practitioners to be copied on the reports
• Additionally, we have developed patient education materials in clear, simple language that cover fasting requirements if applicable, medication instructions, and arrival time.

This comprehensive yet concise format ensures all necessary information is captured efficiently, reducing the need for follow-up and enhancing the overall diagnostic process.

Design Considerations

User-Friendly Layout

The form was designed to be easy to navigate with clear headings, checkboxes, and sufficient space for free text. Grouping relevant information together helps users quickly find and complete necessary sections.

Digital Compatibility

The form was designed to be compatible with Electronic Health Records (EHR) systems, facilitating easy digital input and sharing. It automatically populates GoodX practitioners' information and preferences, as well as patient demographics.

Language and Accessibility

The form uses simple, clear language and the form can be manipulated to increase font size when viewed on an electronic device.  

Implementation Plan

Engagement and Research

We engaged with radiologists, referring practitioners, hospitals, and administrative staff to gather input on what was important to them and the biggest drawbacks of current forms. Inadequate or incomplete clinical information often leads to incorrect tests being ordered, necessitating follow-up calls that consume valuable time and resources.

Drafting

We created initial drafts of the form and circulated them for feedback from key stakeholders, ensuring the form met the practical needs of those using it.

Pilot Testing (Upcoming)

The next step involves implementing the form to identify any issues or areas for improvement.

Revision

Based on feedback from the pilot test, we will revise the form to address any identified issues and improve its functionality.

Evaluation

We will regularly evaluate the form’s effectiveness and make necessary adjustments based on user feedback and changing requirements.

Evaluation Metrics

• Completion Rate: The percentage of forms completed accurately without missing information.
• User Satisfaction: Feedback from healthcare providers and labs on the ease of use.
• Error Reduction: A decrease in the number of errors or omissions in the referral process.
• Efficiency: The time taken to complete and process the form compared to previous methods.

Conclusion

The development of a generic CT-MRI form represents a significant step forward in streamlining diagnostic imaging requisition and ordering processes. By standardising the information captured and improving the efficiency of the requisition/ordering process, this form aims to identify and address common pain points in current requisition and ordering procedures, enhancing operational efficiency across GoodX practitioner practices and healthcare facilities. The ongoing evaluation and refinement of the form will ensure it continues to meet the evolving needs of healthcare practitioners and patients.

Interested in how you can start using this generic CT-MRI form? Book a demo today!