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Questions and Answers on "Change order" button for CT and MRI protocols

The change order button built into our EPIC protocol screens for CT and MRI utilizes our Clinical Scheduling Assistants (CSA) to make calls/emails on our behalf to edit orders that are deemed incorrect after radiologist review during protocol process. This can be a great time saving feature for us radiologists if you don’t have time to track down a clinical team member to verbally discuss the case. If the clinical team member wants to discuss case after being contacted by a CSA, the CSA will facilitate transfer of call to appropriate reading room/radiologist.

Below are common questions/answers regarding the program.

Can we use it for both in-patients and out-patients?

Yes. But you can NOT use the change order button to request changes for exams ordered STAT or LIFE THREATENING. This requires a phone call from radiologist as CSA staff can't get to these studies quick enough in a reliable fashion.

Can we use this button to request changes anytime of day?

The CSA staff are only present to work on our behalf Monday to Friday during business hours 8am-5:00 pm. You CANNOT use the change order button outside of these hours except for routine out-patient scans that are not scheduled to be scanned within 24-48 hours. CSA staff will address those the next business day.

Can I just change the order for in-patient scans when protocoling without using the change order button or talking to the team?

No. You can't change in-patient orders without having a discussion with clinical team.

The protocol by the radiologist has to actually match the order by clinician. If clinical team can't edit the order in EPIC, please write who OK'ed the change from the clinical team in your protocol and the techs can change the order on their end when those details are provided (In these cases you DO NOT need to click the change order button as CSA staff will not be involved). This is to ensure that radiology and clinical team are both in agreement on study to perform.

The CT techs should not be following a protocol that doesn’t match the order. If this happens, they will be instructed to call the reading and get the discrepancy fixed or addressed. Attending radiologist can still opt to disregard the order and scan differently if deemed medically necessary to do so (but this needs documentation in the report so our billing staff will understand the discrepancy).

So, when can I use the change order button on an in-patient?

  1. If the scan is ordered with routine or urgent priority
  2. It is between hours of 8am and 5pm Monday to Friday
  3. You would like the CSA to contact the in-patient medical team on your behalf

If all these conditions are met, click the change order button and write details out in comments on why you want order changed. This applies to in-patients hospitalized at both York Street and SRC campuses and Milford campus (techs will help with this on that campus)

Can I use the change order button for scans ordered by Bridgeport providers or scans booked for our BHOR Park Ave. Or Milford facility?

Yes. We have altered the tech worklists for BHOR and MH sites so the techs will see our change order request and can call provider on our behalf. If they are not comfortable they will reach back out to the radiologist.

Can I use the change order button for ED patients?

No, ED patients still require call to ED provider to get order changed.

How can I reach the CSA taking care of order changes to speak with them (if needed)?

If a Radiologist needs to reach out to the team concerning a Changed Order, the staff members covering will be logged into Primordial with a role of CT or MRI change order (one CSA is usually assigned to each role).