Imaging Decision Support Consultation Requirement Starts February 28

January 27, 2021 | 3 min. to read

Advanced Imaging Decision Support Requirement Begins February 28

A national mandate as part of the Protecting Access to Medicare Act of 2014 requires employed and independent clinicians who place orders for specific high-volume advanced images at Northwestern Medicine to consult a clinical decision support mechanism (CDSM). The CDSM uses evidence-based criteria to assist physicians and providers with ordering advanced diagnostic imaging studies.

In preparation for this mandate, NM is initiating the CDSM within Epic on February 28. At system launch, when you use Epic or EpicCare Link to order an identified PET scan, CT scan, MRI or nuclear medicine exam, the tool will automatically generate a score between one and nine to indicate the appropriateness of the exam for the condition, as shown below. The ordering process will not be blocked. You can continue with the current order or change it to one of the recommended studies. View a tip sheet for more information.

Centers for Medicare and Medicare Services has finalized three circumstances where ordering providers are not required to consult appropriate use criteria:

Emergency medical conditions
Uncontrollable circumstances, like disasters
Inpatient services

Instructions for practices that do not use Epic or EpicCare Link
Use one of the below options to consult a CDSM and generate the required data for PAMA compliance to include on your order.

Submit a paper order. Follow these steps:
- Use an online tool to generate consultation information. Visit the CareSelect Imaging Open Access Portal to register for access to a complimentary online tool designed to streamline diagnostic imaging referrals and generate compliant consultation data. View an Open Access Portal user guide.
- Document on the exam order the decision support session ID and vendor name.
- Attest adherence to recommendation (yes/no).
Use your electronic health record system.
- Calculate the appropriateness score using a CDSM within your EHR or use the CareSelect Imaging Open Access Portal.
- At the time of ordering, enter into the order questions the vendor name and whether the order adheres to the recommendation.

If NM receives identified advanced imaging orders that do not have required information, exams will be scheduled, and the Patient Access team will follow up with the referring clinic.

CMS will not issue penalties for those who do not show proof of CDSM consultation until January 1, 2022. NM is complying now to allow time for ordering clinicians to learn, practice and prepare for the new workflow without penalty. Learn more on NM Interactive (login required).

For more information about signing up for EpicCare Link, visit nm.org.

Resources

Enterprise PACS Transition Begins in March

Access to high-quality, consistent imaging services across NM is an important way for patients to experience a unified health system. Delnor Hospital will be the first NM facility to implement a new integrated picture archiving and communications system (PACS) on March 7, followed by the Central and North Regions on April 18. The West and Northwest Region will go live on June 13. Once the phased transition is complete, physicians will gain seamless access to high-quality radiologic images, including conventional films, CT scans, MRIs, PET scans and other medical images, for diagnostics and treatment in all NM hospital and ambulatory locations.

Training information will be shared soon. For information, visit Enterprise PACS on NMI (login required).

Mammography results standardization: The North and West Regions will go live with Epic Mammography for results reporting on January 31, replacing PedRad and MagView, respectively. Application testing and training are underway. The Central and Northwest Regions already use Epic Mammography. The benefits of an integrated mammography system include:

Mammography history will be available in one system
Results will be immediately available in Epic
Radiologists can use Dragon to dictate into Epic
Reading worklists will standard across the enterprise in Epic.
Result and reminder letters will immediately print or go to MyChart

Support resources will be on-site between February 1 and 3. After February 3, contact MyNM Service Center at 312.926.4357 for support.