Clinical decision support can improve DI

Medical imaging is the cornerstone of patient care in Canada. Medical imaging is used throughout healthcare to identify, diagnose, and treat disease. When imaging studies are required, it is imperative that patients receive the right test at the right time, providing them with the most relevant clinical value throughout the journey.

Canadian Association of Radiologists (CAR) advocates implementation of a nationwide electronic referral system that incorporates clinical decision support (CDS) tools for medical imaging to ensure more timely patient access to images doing. By integrating the CDS tool into the national clinical workflow, patients can be optimally tested based on their symptoms. The goal of these systems is not only to help further reduce the medical imaging backlog, but also to provide support for referrals when choosing the best imaging procedure for a patient.

CAR, supported by the Canadian Medical Association and working with the Canadian Association of Emergency Physicians, the Canadian College of Family Medicine, the Canadian Nurses Association, and the Canadian Rural Physicians Association, has already announced that this national project will be a Canadian-specific imaging referral. The focus was on the development of guidelines and their integration into the CDS system. These evidence-based, peer-reviewed guidelines are available free of charge to guide health professionals’ decision-making processes, enhance care, and enable better communication among health care providers.

Dr. Ryan Margau, co-chair of the CAR Imaging Referral Guidelines Working Group, said: North He is the Chief of Medical Imaging at York General Hospital and he is the Medical Director. “The widespread adoption of CDS tools will take the uncertainty out of ordering medical images by giving medical professionals access to the latest evidence-based knowledge as part of their normal workflow.”

Canada lags behind other developed countries when it comes to CDS-supported electronic referrals. CDS systems for medical professionals who refer to radiology have been implemented with considerable success in other countries. The Royal College of Radiologists in the UK has partnered with MedCurrent Corporation, a leading CDS software company in Canada, to incorporate UK-focused radiology referral guidelines into the CDS software platform called MedCurrent iRefer CDS. The system provides UK clinicians with trusted referral guidelines directly at the point of care.

In addition, the UK’s National Health Service (NHS) has invested millions of dollars in rolling out CDS across the country. Over the next few years, we will launch the Digital Diagnostic Capabilities Program (DDCP) initiative to improve access to diagnostic services for UK citizens.

In 2014, the US Congress approved Advanced Imaging Services (CT, MR, Medicine and PET for Nuclear Medicare and Medicaid Patients).

These developments have not gone unnoticed in Canada, but only a few Canadian hospitals have started implementing CDS solutions. Toronto’s North York General Hospital implemented the MedCurrent iRefer CDS system integrated into the ordering module of the hospital’s electronic medical record (EMR) system.

The Jewish General Hospital (JGH) of Montreal also implements the MedCurrent iReferr CDS. Dr. Huy Le, Chief of Radiology at JGH, said his institution has a history of integrating technology, so he is at the forefront of CDS implementation in Canada. “Dr. Lawrence Rosenberg, his CEO of our institution, had a vision many years ago to embrace digital health.

Dr. Le said this approach led JGH to successfully create an electronic order entry system (OES) earlier this year, which is now in the production and testing phase with clinicians. The interface between CDS and OES has been tested in parallel and is now working.

Meanwhile, Alberta Health Services has integrated a CDS system called CareSelect that focuses primarily on CT and MRI. CareSelect is integrated with AHS’s electronic medical records system, Epic EMR, and is about two-thirds of the way through states. CareSelect classifies referrals as low, medium, or high value based on the American College of Radiology (ACRselect) referral guidelines.

Dr. Bill Anderson, former state medical director of AHS, said the current state of CDS implementation is in data collection mode. He believes the technology can be used for targeted quality improvement work. He added, “In the future, the system could incorporate active alert messages to the referring physician, helping guide the patient’s referral to medical imaging.”

Canada should take note of these examples and, based on their success, identify best practices for the development of CDS referral systems for radiology. This is not limited to medical imaging. Once developed, this system could serve as a blueprint for other Canadian specialties.

“Imaging guidelines should be non-punitive, collaborative tools designed to improve quality, safety and relevance. The need for referral guidelines in Canada To develop comprehensive Canadian guidelines designed to improve the care of Canadian patients and families, we must work with all stakeholders, including patients and referral providers. cooperation is needed,” said Dr. Margau.

Radiologists aren’t the only ones who agree with this approach. Dr. Paul Pageau, Co-Chair of the CAR Imaging Referral Guidelines Working Group and Director of Point-of-Care US, Department of Emergency Medicine at Ottawa Hospital and Assistant Professor at the University of Ottawa, said: Refers to a wide range of medical professionals to help you make informed decisions about medical imaging and treatment choices. Easy access to Canadian guidelines will help achieve this. ”

The federal government has pledged to invest $2 billion in new funding to address waiting times for procedures, including imaging. This will allow us to increase the number of her CT and MRI scanners across the country. A nationwide implementation of the CDS will help ensure that these new resources are used as efficiently as possible.

Canada has an opportunity to improve the overall effectiveness of medical imaging referrals. By consolidating the CDS system in all jurisdictions, radiology departments can reduce imaging backlogs, streamline care for high-priority procedures, improve the workload of radiologists, and improve national image availability. Requests may be better measured and evaluated. The ultimate goal is to improve patient care for Canadians and increase the productivity of the provincial healthcare system.

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