Imaging Clinical Decision Support
Siemens Healthineers is driving quality of diagnostic imaging use and reducing waste with data driven real-time guidance.
Medical imaging has helped transform healthcare. There is no argument as to the importance of medical imaging as a key diagnostic discipline that defines the course of diagnosis and treatment of diseases. Unfortunately, the possible reliance on diagnoses based on inappropriate imaging exams as well as the progressive over-use of imaging studies has led to waste in healthcare and opened the possibility of suboptimal quality of care. In fact, the U.S. Centers for Medicare & Medicaid Services (CMS) estimates that up to 26% of imaging orders are incorrect when placed without evidence-based standards.1
Choosing the right exam has many positive effects, notably on care delivery, operational efficiency, and cost of care. Ordering the right imaging first time not only leads to faster diagnosis, and thus faster care plan implementation, it could also help protect patients from potential unnecessary exposure to radiation.
This “right imaging, first time” impact is also valuable when considering resource limitations in radiology. For example, it’s estimated that by 2022, 47% of total advanced imaging will come from patient aged 65+2. As the elderly population continues to grow, additional stress is placed on existing resources, highlighting the importance of choosing wisely to ensure radiology resources are focused on delivering the information that can impact quality of care. And cumulatively, reducing unnecessary or unwarranted imaging, and focusing on imaging studies aligned to the patient’s clinical presentation, eliminates waste thereby reducing cost.
A priority among payers is fostering the appropriate use of imaging to help standardize imaging use, encourage alignment to evidence-based best practices, and decrease imaging waste without discouraging or hindering ordering physicians. The Centers for Medicare and Medicaid Services (CMS) published the Protecting Access to Medicare Act (PAMA) mandate (currently in educational and operations testing period, and scheduled to be in full implementation January 20223) with the criteria that an ordering professional must consult with a CMS-qualified Appropriate Use Criteria (AUC) provided by a qualified Provider Led Entity (qPLE)) through a CMS-qualified clinical decision support mechanism (CDSM) when ordering imaging exam.
Furnishing professionals (such as radiologists and cardiologists) must report the results of the AUC consultation on the claim submitted in the Medicare beneficiary claim in order to meet the mandate or otherwise risk payment denial by Medicare. And because PAMA AUC is mandated by CMS, it is making its way into community hospitals large and small across the U.S.
Empowering Data-Driven Decision-Making
At the point of order entry, providers need convenient access to evidence-based standards that consider the patient’s clinical condition when offering the recommendation on appropriate imaging studies. Imaging CDSM should be seamlessly embedded into the physicians’ workflow thereby enabling operational efficiencies, while also improving communication between clinicians and the radiology departments– all indicative of what true healthcare digitalization can bring into clinical practice.
Radiology departments are often at the forefront of changing clinical practice through digitalization. Driving clinical decision support (CDS) adoption among the ordering or referral community by offering comprehensive services is certainly a new chapter in the radiology departments digitalization journey. To foster this culture of change, and ensure success, there is a need to continuously measure the impact on operations, the rate of adoption and the adherence to guidelines with analytics tools, a necessary feedback as part of continuous process improvement.
As a visionary leader in healthcare, Siemens Healthineers understands the importance of transforming care delivery through digitalization, and especially enabling data driven decision making at the point of care. Siemens Healthineers Medicalis Clinical Decision Support (Medicalis CDS) system is one of the earliest pioneers in this domain.
Medicalis CDS brings together almost 18 years of development executed in collaboration with key thought leaders and renowned academic institutions, with a shared focus on improving care, increasing clinical adoption and seamless integration in clinical practice.
Adding Value, Not Distractions
The main philosophy used in developing Medicalis CDS is ease in accessibility as well as adaptability to the local needs. To accommodate the physician’s workflow at the point of order entry, the Medicalis CDS mechanism is deployable via multiple methods - from a simple cloud hosted consult portal, to imbedded solution within the existing systems such as the electronic medical record (EMR) and other computerized physician order entry (CPOE) systems like Medicalis Referral Management.
Embedded workflow in existing systems reduces redundant data entry, enables full transparency of the references and clinical source as strength of evidence, and eliminates ‘low value’ alerts and alert fatigue, providing actionable and unambiguous recommendations.
Siemens Healthineers Medicalis CDS helps imaging facilities meet the PAMA mandate by offering a CMS qualified clinical decision support mechanism in partnership with leading CMS-qualified Provider Led Entity (qPLE) institutions and organizations. It also provides a selection of CMS-qualified appropriate use criteria. Medicalis CDS measures results through analytics to improve deployment and thus enable data driven decision making at the point of care.
Learn more about how Siemens Healthineers can support transform potentially disparate departmental imaging operations into an integrated imaging service line and meet regulatory dynamics. Please feel free to also reach out to your local Siemens Healthineers service organization for more details.
Written by Siemens Healthineers
The product/feature (here mentioned) is not commercially available in all countries. Due to regulatory reasons its future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details.
[1] Source: https://innovation.cms.gov/Files/reports/MedicareImagingDemoEvalRTC.pdf, page 51
[2] Source: Analysis from Advisory Board’s Market Scenario Planner
