We hypothesize that a clinical decision support system (CDSS) designed with Patient-specific reminders yields superior performance than that with Non-patient-specific reminders in preventing contrast-induced nephropathy.~A 3-arm randomized controlled trial (RCT) will be performed by cluster randomization using physicians as the unit of allocation. Physicians in 3 university medical centers will be randomly assigned into 1) patient-specific arm with Anti Contrast-Induced-Nephropathy(Anti-CIN) reminder, 2) non-patient-specific reminder arm, and 3) the control arm without any reminders, respectively.~The patient-specific alert, Anti-CIN system, is designed as a real-time CDSS implementation on CPOE for monitoring physician's contrast-enhanced CT and IVP orders. Computerized pop-up reminders provide the patient-specific encounters with optimal decision options when patients are at a high CIN risk or patients with unknown risk factors are encountered. Non-patient-specific reminders always pop up no matter whether the patient is at a high risk or not.
The investigators hypothesize that a Clinical Decision Support System (CDSS) designed with Patient-Specific reminders yields superior performance than that with Non-patient-specific reminders in preventing contrast-induced nephropathy.