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

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

Feb 06, 2023 148 likes •315 views

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 *

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SLIDE 1

Context Integration of EMR and PACS Increases Radiologist Use

  • f EMR

John Mongan, MD, PhD David Avrin, MD, PhD Department of Radiology, UC San Francisco

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SLIDE 2

PACS-EMR Context Integration

  • Clinical history essential for accurate interpretation

* EMR data changes interpretation in 6% of cases1

  • 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.
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SLIDE 3

Integrated PACS-EMR workstation

Worklist Dictation Images EMR

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SLIDE 4

Why doesn’t everyone have integration?

  • $$$
  • < 50% adoption even in academic centers1
  • No quantitative data on benefits
  • 1. Forsberg et al. J Am Coll Radiol. ePub ahead of print 2016 Mar 22
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SLIDE 5

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?
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SLIDE 6

Time to access most recent clinic note

10 20 30 40 50 60

Pre-integration Post-integration Time to access clinic note (seconds)

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SLIDE 7

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)

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SLIDE 8

Events collected

  • 37 users
  • 51,926 studies
  • 21,018 EMR accesses
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SLIDE 9

EMR Usage

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SLIDE 10

EMR Usage

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SLIDE 11

EMR Usage

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SLIDE 12

EMR Usage

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SLIDE 13

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
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SLIDE 14

Impact of increased EMR usage

  • 8.2 percentage point increase in EMR access
  • EMR data changes interpretation in 6% of cases1
  • Integration changes 1 read in every 200 cases
  • 1. Franczak et al. Health Aff. 2014 May;33(5):800–6.
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SLIDE 15

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

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SLIDE 16

Thank you

  • Questions?