Clinical Decision Support Presentation
September 02, 2020Clinical Decision Support Presentation
Information
- ID
- 5527
- To Cite
- DCA Citation Guide
Transcript
- 00:05In conjunction with the epic upgrade,
- 00:07there will be an update to
- 00:09clinical decision support.
- 00:11Which is required by pama to
- 00:14support their updated regulations?
- 00:16There will be changes to the ordering of
- 00:19some CTMR in nuclear medicine procedures.
- 00:23These changes use the latest
- 00:24AI technology to make ordering
- 00:26more efficient and accurate.
- 00:30First you will choose your order priority.
- 00:33Note in the outpatient setting,
- 00:34select physician appointment directly
- 00:36after test if you are seeing the patient
- 00:40the same day as their radiology exam.
- 00:43This will ensure that the
- 00:45radiologist has interpreted the
- 00:46study before you see your patient.
- 00:49Now you will enter the reason for the
- 00:51radiology procedure you are ordering.
- 00:53This has been updated for easier use.
- 00:57You can simply use the checkboxes,
- 00:59which is the current functionality.
- 01:01Or you can enter free text
- 01:03which offers new functionality.
- 01:05You do not need to use both.
- 01:09To maintain compliance, the free text
- 01:12option will be checked by AI and a list of
- 01:16structured indications will be presented.
- 01:18You will also be alerted automatically if
- 01:21a different test may be more appropriate
- 01:24for the indication you entered.
- 01:26Using the new text to entry option,
- 01:28you will no longer need to search through.
- 01:31It lists of indications.
- 01:34One of the following workflows
- 01:36could occur based on the AI results.
- 01:38First, a list of suggested indications
- 01:40may be presented in a pop up.
- 01:45Select from these suggested
- 01:47indications search for another.
- 01:50Or select the option labeled.
- 01:53I can't find an indication.
- 01:56Second, no indications could be suggested
- 01:59based on the free text reason for exam.
- 02:03In this case, the order will be signed
- 02:07without requiring further action.
- 02:09The Smart Suggestion Windows suggest the
- 02:11appropriate exam for the selected indication
- 02:14and provides other useful information.
- 02:17Such as radiation exposure and a link
- 02:20to evidence based recommendations
- 02:22for imaging exams.
- 02:24The color bars quickly show whether
- 02:27the study is rated as appropriate
- 02:30for pama compliance.
- 02:31If it is appropriate,
- 02:33it will show green marginal yellow
- 02:35and if inappropriate it will be red.
- 02:40For a CT chest with contrast,
- 02:42an indication of dyspnea, chronic chest
- 02:44wall or pleural disease was selected.
- 02:50Notice a chest. See T with Ivy.
- 02:52Contrast is coded green.
- 02:56The provider can click confirm in order
- 02:58to continue as it is inappropriate
- 03:00procedure based on indication.
- 03:06In contrast, if this pinilla
- 03:08chronic interstitial lung
- 03:09disease suspected was selected.
- 03:13The see T chest with Ivy
- 03:15contrast was quoted as yellow.
- 03:19The new smart suggestions screen
- 03:21makes ordering alternative
- 03:22studies much faster and easier.
- 03:27The provider can click replace in order
- 03:30to select the most appropriate exam.
- 03:33In this case, ACT chest without Ivy contrast.
- 03:38Lastly, an indication of
- 03:39cough persistent is selected.
- 03:41This is coded red.
- 03:44Again, the new smart suggestion
- 03:46screen makes ordering alternative
- 03:48studies simple and efficient.
- 03:50The provider can click replace in order
- 03:52to select the most appropriate exam.
- 03:55In this case they chest X Ray.
- 03:59In summary orders can still be entered
- 04:02in the conventional way using the
- 04:05structured indication checkboxes.
- 04:07New functionality will become
- 04:09available allowing you to enter the
- 04:12procedure indication as free text.
- 04:14AI will then be applied to the free
- 04:17text to suggest structured indications.
- 04:21If AI cannot suggest an indication you
- 04:23will be able to order the procedure using
- 04:26the free text indication you entered.
- 04:30You will be showing the appropriateness
- 04:32of the procedure you are ordering.
- 04:35And can easily replace that
- 04:37procedure with the procedure that
- 04:39is ready to be more appropriate.
- 04:41The system will also allow
- 04:43for continuous feedback and
- 04:45improvement to the ordering system.
- 04:47Radiology will track.
- 04:49How frequently providers accept the
- 04:52AI suggested indications and how often
- 04:55providers cannot find an indication.
- 04:58This will allow for improvements
- 05:00to the CDs ordering system.
- 05:02Radiology will also track their proportion
- 05:06of inappropriate studies ordered.
- 05:08In preparation for changes in CMS
- 05:11reimbursement based on order appropriateness,
- 05:13which will start in 2022.
- 05:17Radiology will reach out to ordering
- 05:19providers as needed to address frequent
- 05:21apparently inappropriate orders.
- 05:25Thank you for watching the overview of the
- 05:29clinical decision support Pama Update.