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New radiology order priority options go live in January 2023

Nov. 29, 2022, 4:09 PM


by Leigh MacMillan

The radiology order entry system in eStar will be updated to allow providers to choose from four options — based on a patient’s medical needs — when requesting studies for hospitalized and emergency department patients. The update is scheduled to go live on Jan. 11, 2023.

Jake Block, MD

Currently, the radiology electronic order entry systems at VUMC only allow for two options: “STAT” or “routine,” reflecting an outdated approach that dates to paper requisitions and legacy computerized systems, said Jake Block, MD, vice chair for Clinical Operations in the Department of Radiology and Radiological Sciences.

“For a radiology department performing a few hundred studies a day, this sufficed for some time. But now we are talking about an imaging enterprise performing closer to a million studies a year, with up to 50% of inpatient cases ordered at the highest priority level,” Block said. “We need a better way of stratifying incoming orders and prioritizing cases both for the superb staff of technologists performing the exams as well as the radiologists interpreting these studies.”

Recent updates in Vanderbilt PACS (picture archiving and communication system) as well as the associated radiology information systems have allowed for the development of new acuity or activation levels. Candace Jones, MHA, MBA, PMP, senior project manager, led a dedicated team of Health IT professionals to implement the new order entry. After the go live date, eStar users will have the following options when placing CT or MRI orders on admitted or emergency room patients at both Vanderbilt University Hospital and Monroe Carell Jr. Children’s Hospital at Vanderbilt:

  • Medically urgent
  • Discharge pending within 24 hours
  • Inpatient (not otherwise specified)

Block said, “We devised these options to stratify orders in such a way that recognizes varying levels of patient illness and acuity. At the same time, we recognize that expediting the discharge of patients as their hospital stay is concluding and making those beds available for other ill patients saves lives too.”

A newly approved policy, “Radiology Activation Criteria for Admitted and Emergency Department Patients,” provides governance for the use of the new priority levels. It is available on the VUMC PolicyTech website (

Block has been demonstrating the new order entry system at a variety of venues, including numerous medical director meetings at VUH and Monroe Carell. To arrange a preview of the system for your provider group prior to the go live on Jan. 11, 2023, or for other questions, contact

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