Skip to Main Content

Clinical Decision Support Presentation

September 02, 2020

Clinical Decision Support Presentation

ID
5527

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.