Context Integration of EMR and PACS Increases Radiologist Use of - PowerPoint PPT Presentation

Context Integration of EMR and PACS Increases Radiologist Use of EMR John Mongan, MD, PhD David Avrin, MD, PhD Department of Radiology, UC San Francisco

PACS-EMR Context Integration • Clinical history essential for accurate interpretation * EMR data changes interpretation in 6% of cases 1 • EMR historically separate from PACS • Context integration opens same patient in PACS, EMR 1. Franczak et al. Health Aff. 2014 May;33(5):800–6.

Integrated PACS-EMR workstation Worklist Images EMR Dictation

Why doesn’t everyone have integration? • $$$ • < 50% adoption even in academic centers 1 • No quantitative data on benefits 1. Forsberg et al . J Am Coll Radiol. ePub ahead of print 2016 Mar 22

Does integration provide quantifiable benefit? • Context integration implemented at UCSF in August 2014 • Does integration save radiologist time? • Does integration increase radiologist use of EMR?

Time to access most recent clinic note 60 Time to access clinic note 50 40 (seconds) 30 20 10 0 Pre-integration Post-integration

Data collection • EMR usage data obtained from security audit logs * Trainee accounts on active clinical service across sample period * “Summary report” and protocol module accesses removed * Non-clinical accesses removed • Study volume data obtained from report database • Sample period 180 days prior, 180 days post (following 60 day run-in)

Events collected • 37 users • 51,926 studies • 21,018 EMR accesses

EMR Usage

EMR Usage

EMR Usage

EMR Usage

Impact of time savings • Each EMR access 46 seconds faster • Multiplied by average number pre-integration accesses, extrapolated to one year • Integration saves over 8 hours per radiologist per year

Impact of increased EMR usage • 8.2 percentage point increase in EMR access • EMR data changes interpretation in 6% of cases 1 • Integration changes 1 read in every 200 cases 1. Franczak et al. Health Aff. 2014 May;33(5):800–6.

Conclusion • PACS-EMR integration achievable with software available today • Integration saves time and likely improves accuracy • Effects are durable and self-reinforcing • EMR integration should be considered an essential feature of a PACS workstation

Thank you • Questions?