The Impact of CDs and Image Sharing on Radiology Kang Wang Ph.D, CEO, HealthFortis Amy Vreeland, SVP Strategic Accounts, lifeIMAGE 9/24/2013
Mar 29, 2015
The Impact of CDs and Image Sharing on
RadiologyKang Wang Ph.D, CEO, HealthFortis
Amy Vreeland, SVP Strategic Accounts, lifeIMAGE
9/24/2013
Value of Clinical Decision Support
Value of Image Exchange
Power of the two systems working together
Agenda
It’s also a Patient Safety issue
“… just from overuse of CT, will result in 12 preventable radiation-induced cancer deaths a day”*
"A 20-year old woman who gets an abdominal-pelvic CT scan (i.e., just about any young woman coming to the ED with belly pain) has a 1 in 250 chance of getting cancer from that single scan.“**
*Robert Stern, Patient-centered imaging, Am J Med 2012; 125:115
**Dr. Rebecca Smith-Bindman - professor of Radiology, Epidemiology, and OB/GYN at UCSF in http://community.the-hospitalist.org/2011/02/11/a-game-changing-statistic-1-in-250
Solutions
•Speed bumps
• RBMs
• Referral pre-authorization
•Claim analysis and provider profiling
Current solutions and their problemsProblems•Human intensive
•Trying to change decisions that are made
•Little physician involvements
•No consistent evidence based decision making
•No financial incentives for physicians
Current solutions and their problems
Clinical Decision Support (CDS) Order Entry System
Integrated with EHRs
A better solution
Decision Support at the point of Decision
A better solution
Proactive Decision Support—Decision support BEFORE the decision is made—Symptom/Diagnosis driven decision support—Change of the current CPOE order workflow—More effective: the right exam is the easiest to order
Passive Decision Support—Judgment AFTER the decision is made—Procedure driven decision support—Keep the current CPOE order flow, add a CDS step
after order submission—Less effective: physicians don’t like to be judged
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Proactive vs. Passive CDS
EHR integration vs. stand along CDS order entry
Comprehensive rule sets with option to customize—American College of Radiology, —ACC—ODG—Ability to set institution specific rule set
Reporting Module: provides actionable information
KB Editing Tool: can you publish your own guidelines?
Cloud hosting vs. local installation
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CDS: What to look for
Tight integration with EHRs— Single sign-on— Patient context sharing— Patient chart information passed to CDS— Real time submission of the CDS result
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Integrated with physician workflow
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Data Mining
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Knowledge base editing
Centrally managed content—Regular updates from content providers—Multi-tenant system
• Each customer can subscribe to its preferred content or create customized content
Centrally managed system—Minimal client side IT requirements—Frequent system updates
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Cloud-based deployment model
Trend of Order Distribution by Appropriateness Score
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System Adoption
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March 18th
System Adoption98% orders follow guidelines (up to 67%)
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CDS: demo
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The Network of NetworksHighest Ranking Providers
• 16 of 20 best Cancer• 10 of 20 best Gastroenterology• 10 of 20 best Gynecology• 10 of 20 best Cardiology• 10 of 20 best Neurosurgery • 10 of 20 best Rheumatology• 9 of 20 best Geriatrics• 9 of 20 best Urology• 7 of 20 best Pulmonary• 7 of 20 best Orthopedics
561 M Images / 2.64 M Exams
• 205 hospitals - Connect to another 410 hospitals • 35,000 users - 12,000 monthly active users
Our customers represent• 54.9 M outpatient visits/year• 7.4 M ER visits/year• 32.0 M radiology exams/year• 85,000 physicians (12% of total)
No.1 ranked hospitals in 18 out of 27 states & D.C.
A future proof platform for image sharing
1 Outside exam ingestion
Referral workflow & publishing results
Managing connections
Image enabled community & CDS
Cross community sharing
Baseline: PACS and EMR is already in use with an existing enterprise viewer
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Image-Enabled HIE Demo
Health Information Exchange (HIE)Physicians access to priors, and relevant priors alert during an order
CommunityPatient ID
Physician Office 1HIE Portal
Physician Office 2
Imaging Orders
Imaging Orders
lifeIMAGE
Image MetadataPACS
C: Find
Imaging Service Provider Site
HL7 ReportRIS
Repository
Registry
LILA
Metadata
Reports &Thumbnails
Member ID (Patient IDs)& local MRN
Patient ID
Imaging Results
Imaging Results
Imaging Results
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CDS & Image Sharing Integration: demo
CDS can help to increase guideline compliance and reduce
utilization
Imaging sharing facilitates coordinated care delivery,
reduces duplicated radiology orders, and provides
meaningful Return on Investment
An integrated CDS and Image sharing platform helps to
improve patient and care giver experience with their
radiology services
Thank You