Radiology Clinical Decision Support FAQs: EPIC Users

What is the national clinical decision support mandate?

This is national legislation that requires all ordering clinicians to consult ‘appropriate use criteria’ for outpatient imaging requests.

Is this new change confined to Yale New Haven Health?

No, all imaging providers across the country are required adopt this change.

When will this start?

January 1st, 2020

Is this for all outpatient imaging requests?

No, the mandate only refers to CT, MRI, PET-CT and Nuclear Medicine exams.

How do I consult ‘appropriate use criteria’ when ordering a test?

YNHHS will use a tool called CareSelect which will be integrated into EPIC ordering screens.

What will I see when I request a study?

When you select one of the pre-supplied indications for the exam, a Best Practice Alert will launch giving you a score from 1 (least appropriate) to 9 (most appropriate).

What do I do if my imaging request is graded as being of low appropriateness?

You can continue with your original order or choose from a list of more appropriate imaging tests for the clinical indication at hand.

Will data be collected on my appropriateness ordering patterns?

From 2023, CMS may identify referrers whose imaging requests are most often of low appropriateness.

Where can I get more information on this?

Visit the Centers for Medicare & Medicaid Services website or your radiology department leadership team whose contact details are on the attached letter.