confidential and proprietary information – do not circulate

note: CDS alert displays using Epic’s native best practice alerts;

Epic does not allow use of actual screenshots

Choosing Wisely: Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.(American Geriatrics Society)1, 2, 3

Reasons for override:sleep disorder end of life care withdrawal / DT

non-drug options failed

peri-procedural anesthesia

physician starts order

in EMR

likely appropriat

e

targeted alerts integrated into workflow

order placed

order cancelled

likely unnecessary

✓

✕

Hyperlink: Choosing Wisely – American Geriatrics SocietyInformation for Patients: Use of Sedatives in Elderly Patients

confidential and proprietary information – do not circulate

predictor of success adjusted OR

automatic provision of decision support as part of workflow

112

provision of decision support at the time and location of decision making

15

provision of recommendation rather than just an assessment

7

computer-based generation of decision support

6

75% of decision support interventions succeed when the information is provided to clinicians automatically, whereas none succeed when clinicians are required to seek out the advice decision support

is most effective at the point of

careSource: Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice

using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005 Apr 2;330(74794):765 . PMID: 15767266

confidential and proprietary information – do not circulate

provider notification (BPA)

hospital staff(c-suite, medical

directors, analytics, providers)

standard Epic import

analyticsengine

nightly secure FTP feed from Clarity1

display of order and alert firing information, including provider

response

initial implementation !

note: CDS alert displays using Epic’s native best practice alerts (BPA); Epic does not allow use of actual screenshots

how is the solution delivered?

1. includes order data and each instance of BPA firing with provider name and response

SQL scripts for Clarity

confidential and proprietary information – do not circulate

opportunity dashboard

helps identify savings opportunities associated with various alerts

confidential and proprietary information – do not circulate

outlier dashboard

identifies providers with the largest deviation from standard practice based on their alerting and ordering patterns

confidential and proprietary information – do not circulate

provider activity

provides a detailed breakdown of provider’s ordering and alerting activity

confidential and proprietary information – do not circulate

activity dashboard

provides an operational overview of alert and provider activity

confidential and proprietary information – do not circulate

high cost labs

high cost pro-cedures

high cost med-ications

CT and MRI imaging

nuclear imaging

our content lowers

waste & cost

confidential and proprietary information – do not circulate

Protecting Access to Medicare Act of 2014 (PAMA) is signed, with section 218 of H.R. 4302 outlining the Radiology CDS requirements

March 31, 2014

CMS begins data collection period for identification of “outlier” ordering providers with low AUC adherence rates relative to their peers

January 1, 2018

CMS will no longer reimburse providers ordering advance diagnostic imaging exams unless the provider consults an appropriate use criteria (AUC) prior to ordering

January 1, 2017

Ordering Providers that CMS has identified as “outliers” will be required to obtain prior-authorization

January 1, 2020

Stanson will provide content that satisfies the requirements of the legislation with the same

methodology, integration, and “look and feel” as non-imaging related content

confidential and proprietary information – do not circulate

mean

2 SD

2 SD

date most alerts deployed

significantly reducedtargeted imaging tests

confidential and proprietary information – do not circulate

Value Improvement Predictor (VIP) Program – FREE 90 Day Trial

Choosing Wisely BPAs deployed silently

full access to Stanson analytics

customized savings analysis 

Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.

Don’t screen for carotid artery stenosis (CAS) in asymptomatic adult patients.

Avoid nonsteroidal anti-inflammatory drugs (NSAIDS) in individuals with hypertension or heart failure or CKD of all causes, including diabetes.

Don’t do imaging for low back pain within the first six weeks, unless red flags are present.

Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms of active coronary disease, heart failure or stroke.

included recommendations

confidential and proprietary information – do not circulate

Value Improvement Predictor (VIP) Program – FREE 90 Day Trial

Choosing Wisely BPAs deployed silently

full access to Stanson analytics

customized savings analysis 

Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.

Don’t screen for carotid artery stenosis (CAS) in asymptomatic adult patients.

Avoid nonsteroidal anti-inflammatory drugs (NSAIDS) in individuals with hypertension or heart failure or CKD of all causes, including diabetes.

Don’t do imaging for low back pain within the first six weeks, unless red flags are present.

Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms of active coronary disease, heart failure or stroke.

included recommendations