Connecting clinical workflows with Advanced VisualizationRick Gouse

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Unify Web Viewing & Smart Apps

OptimizeWorkflows and

Reporting

ConnectCare pathways & Information

Sharing

Visualization & Accessibility

Workflow& Collaboration

Connectivity & Analytics

Radiologist

Specialized

Department

Connected

Enterprise

Open

Community

Dynamic

Multi-ology information Viewer

Clinical Archive

InfrastructureLeverage

Investments & Optimize

Costs

Where is Workflow in Enterprise Imaging?

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The Evolution of “RIS”

Intake and Manageme

nt of Relevant

Data

Pre-exam Tasks

Intra-exam Procedures

Post Exam Directives

Follow-up Tracking

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The breakdown of workflow

Workflow Application

AreasIntake and

Management of Relevant

data

Pati

ent

Reg

istr

ati

on

Ord

er

Pla

cem

en

t and

appro

pri

ate

ness

Refe

rrin

g P

hysi

cian

Noti

fica

tions

/ w

ork

list

Pre Exam Workflows

Ord

er

and S

ched

ule

R

efinem

en

t

Pati

ent

and e

xam

cl

inic

al d

ata

mgt.

Exam

exact

ness

an

d

pro

toco

ling

Intra Exam WorkflowsPa

tient

arr

ival an

d p

re-

exam

task

s

Intr

a-e

xam

task

s

Exam

QC

an

d Im

age

Mgm

t

Nurs

ing C

are

Charg

e C

aptu

re

Post Exam Workflows

Inte

rpre

tati

on a

nd

report

cre

ati

on

Report

revie

w, appro

val

and s

ignatu

re

Post

-exam

an

d f

ollo

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up

dir

ect

ives

MD

T a

nd o

ther

revie

ws

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Customer Defined Workflow Controls

Workflow control framework providing:

• Unlimited Exam specific tasks and task groups

• Tasks supported by Rich Content and User Control

• Ability to build fine-grain workflow scenarios from order to exam results distribution and post-exam follow-up

• Tracking tasks execution with timing, duration and delays.

• Workflow control hub embedded to Imaging Desktop for basic Tech Workflows: begin, complete, QC exam

• Workflow control features available for RIS-IC user via legacy UI

Trigger

Worklist

Task

Data

Step N

Result / Status

Action Done

Intake and Manageme

nt of Relevant

Data

Pre-exam Tasks

Intra-exam Procedures

Post Exam Directives

Follow-up Tracking

Intake and Management of Relevant Data

Role Activity

Referrer CT Enterography exam ordered on a patient with ongoing abdominal pain

Scheduler History and indications obtained

Scheduler Allergies recorded

Scheduler Exam scheduled

Scheduler Patient education performed

If patient is allergic to IV contrast, an MRI may be done instead (Gadolinium used as contrast in MRI may be better tolerated)

Intake and Manageme

nt of Relevant

Data

Pre-exam Tasks

Intra-exam Procedures

Post Exam Directives

Follow-up Tracking

Pre-Exam Tasks

Role Activity

Billing clerk Pre-authorization documented

Radiologist Review of all relevant forms/labs/data

Radiologist Exam protocoled

Nurse/Tech GFR calculated and reviewed

Nurse/Tech Patient education performed

Nurse/Tech IV started

Nurse/Tech Volumen given w/instructions

A GFR greater than 60 is desired; between 60 and 40, the patient is asked to orally hydrate for a couple days post injection; and lower than 40, the patient needs to be hydrated with IV fluids

before and after the exam, and be monitored by a nurse during the exam timeframe.

Intake and Manageme

nt of Relevant

Data

Pre-exam Tasks

Intra-exam Procedures

Post Exam Directives

Follow-up Tracking

Intra-Exam Procedures

Role Activity

Nurse/Tech Document contrast

Nurse/Tech Patient education performed

Nurse/Tech Start IV contrast

Tech Perform imaging study

Nurse/Tech Monitor IV

Tech Perform exam tracking steps

Nurse/Tech Monitor the patient’s vital signs

If any extravasation of IV contrast occurs during the exam, an “Extravasation Report” needs to be filed and proper nursing care for the patient performed.

Intake and Manageme

nt of Relevant

Data

Pre-exam Tasks

Intra-exam Procedures

Post Exam Directives

Follow-up Tracking

Post-Exam Directives

Role Activity

Nurse/Tech Remove IV

Nurse/Tech Monitor the patient’s vital signs

Tech Complete exam tracking steps

Radiologist Review imaging for completeness

Nurse/Tech Provide and document post-exam instructions

Radiologist Interpret the study and Record recommended imaging or clinical follow-up

Coordinate care with other specialties, as needed (for example, if the patient is recommended to have a small bowel biopsy based on the results of imaging).

Intake and Manageme

nt of Relevant

Data

Pre-exam Tasks

Intra-exam Procedures

Post Exam Directives

Follow-up Tracking

Follow-up Tracking

Role Activity

Care Coordinator

Document recommended imaging or clinical follow-up

Nurse/Care Coordinator

1-day post-exam patient call to check IV site/general condition

Radiologist Review pathology if biopsy was ordered

QA Monitor Document compliance with PQRS and Centers of Excellence measures

Care Coordinator

Monitor compliance with recommended imaging or clinical follow-up

Full documentation of all events in the care continuum allows establishment of “models of care”, supports audit reports of documented events for accrediting

bodies and for P4P, and provides care-specific marketing analytics.

Questions?

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