Diagnostic Imaging Key Initiative Update: Enterprise PACS and Clinical Decision Support

September 24, 2020 | 3 min. to read

Enterprise PACS Transition Will Go Live in Phases Starting in January 2021

Access to high-quality, consistent imaging services across Northwestern Medicine is an important way for patients to experience a unified health system. NM Enterprise PACS Transition is underway to implement single, integrated picture archiving and communications system (PACS) from more than 65 different imaging solutions currently in use.

Once the phased transition is complete in June 2021, physicians will gain seamless access to high-quality radiologic images, including conventional films, CTs, MRIs, PET scans and other medical images, for diagnostics and treatment, in all NM hospital and ambulatory locations, including Immediate Care Centers, Cancer Centers and orthopaedic centers. 

Visage standard visualization tool and Nuance Primordial workflow orchestrator will replace the following regional systems:

• Central Region: GE PACS, Sectra PACS
• North Region: Agfa PACS, Hologic
• Northwest Region: Merge PACS, Hologic
• West Region 
  • Central DuPage Hospital: McKesson PACS, Hologic
  • Delnor Hospital: Merge PACS, Hologic
  • Kishwaukee Hospital and Valley West Hospital: Agfa PACS, Hologic

​Transition activities

The design and build phase of the workflow orchestrator and advanced visualization viewer is underway and will continue through early fall. On January 31, 2021, Epic mammography resulting system will go live in the North and West regions. The Central and Northwest regions already use Epic.
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For more information about the Enterprise PACS Transition timeline, governance and news, visit the Enterprise PACS Transition page on NM Interactive by following this path: NMI home > System Initiatives > Enterprise PACS Transition (NMI login required)

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​Clinical Decision Support for Advanced Imaging Goes Live December 6
 
The Protecting Access to Medicare Act (PAMA) is a law that affects all physicians, APPs and facilities across the nation who provide care for Medicare patients, but many are unaware of its implications. As part of PAMA, the Centers for Medicare and Medicaid Services requires clinicians who order specific advanced imaging exams such as CT, MRI, nuclear medicine and PET, to consult appropriate clinical decision support (CDS) tools. At face value, the new requirements seem burdensome, but they will enhance decision-making in the clinical workflow, reduce unnecessary or inappropriate imaging, thus improving quality and safety of care, and provide valuable data for utilization management.
 
Here's what you need to know:

• Starting on December 6, image ordering providers at NM must consult appropriate use criteria. This allows for a full year to educate and test functionality before the law goes into effect January 1, 2022. At that time, claims for advanced imaging orders placed without consulting appropriate use criteria will be denied.
• Ordering clinicians will see the CDS alert for each advanced imaging study to help them order the most appropriate imaging for specific medical conditions.
• Claims filed through December 2021 will be paid regardless of documentation, according to the American College of Radiology.  

​Who does this impact?

• Physicians and clinicians who order imaging
• Clinical staff working under the direction of ordering physician
• Patients awaiting testing approval and scheduling

What facilities are affected?

• Ambulatory clinics
• Hospital inpatient services, except emergency conditions
• Hospital outpatient departments, including non-emergency conditions in the ED
• Ambulatory surgery centers
• Independent Diagnostic Testing Facilities (IDTFs)

​For more information, view the Appropriate Use Criteria Program page on cms.gov.