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Ms. Doe visits the Emergency Department for flank pain. Computed tomography (CT) of her abdomen and pelvis is performed. Her symptoms subsequently resolve.
Two weeks later, she visits her primary care physician; labs demonstrate mildly abnormal liver enzymes. A liver ultrasound is requested. Had her primary care physician known that a recent CT already confirmed the presence of a fatty liver, ultrasound would not have been pursued. Ms. Doe’s story is an example of unintentional duplicate imaging—a common occurrence contributing to nearly $12 billion wasted annually!

At present, no systems exist to prevent unintentional duplicate imaging. We propose an alert system for physicians to identify possible cases at the time of order entry. It would include an option for providers to request a second review of prior imaging in the setting of new non-acute clinical questions in a manner similar to how academic radiologists render secondary interpretations for outside examinations.