March 2019

During ECR 2019, the ESR showcased ESR iGuide, the clinical decision support solution for medical imaging referrals, as part of its mission to improve radiation protection and quality & safety in radiology.

Among the highlights were two Coffee & Talk (Open Forum) sessions on Thursday, February 28, with speakers presenting adoption strategies for CDS and referral guidelines across Europe, the Middle East and Africa. Then-ESR 1st Vice-President Prof. Boris Brkljačić introduced attendees to a pilot programme in Croatia led by the Ministry of Health, where ESR iGuide was implemented in four different hospitals. An initial “silent-mode” data collection phase revealed that in every setting, around 25 percent of referrals are inappropriate. Over time, some hospitals showed significant improvement, with appropriateness rates reaching 91 percent after approximately 18 months of ESR iGuide use in clinical practice.

Dr Henriettae Ståhlbrandt, president of the Swedish Society of Radiology, presented the ESR iGuide implementation at four primary care centres and a number of inpatient departments at Jönköping county hospital. After an initial, limited integration indicated a substantial difference in the quality of CDS vs. non-CDS referrals, a fully integrated version of ESR iGuide went live in November 2018.

Belgium is exploring the option of tendering for nationally coordinated pilot implementations of CDS, followed by a full national roll-out, according to Prof. Geert Villeirs, the president of the Belgian Society of Radiology.



The ESR puts a particular focus on supporting the adoption of guidelines in low- and middle-income countries across the Middle East and Africa. The ESR’s free ESR iGuide portal is a simple and user-friendly solution for utilising CDS in environments where the digitalisation of imaging services is not yet at a sufficiently advanced stage so that fully integrated decision support workflows are not feasible. With the support of the International Atomic Energy Agency (IAEA), the ESR is working to improve the appropriate utilisation of radiology services to patients beyond Europe.


The sessions are available via ECR Online! (Free registration required)

ESR iGuide adoption in Europe

ESR iGuide adoption in the Middle East & Africa


For more information on ESR iGuide adoption, please refer to our ECR 2019 EuroSafe Imaging poster.