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Saturday, July 13, 2013

Can I ask You a MeaningfulUse Question on CDS and Imaging?

This question came in via Ask me a Question. Since 1) I'm on vacation and 2) I've little experience with Radiology workflows, I thought I'd see what crowd sourcing can do to get an answer.  Here is the question:

Hi Keith 
I was wondering if you had any thoughts how a vendor for a Radiology Information System program would implement clinical decision support for MU Stage 2. It seems like the MU CDS rules are geared more towards providers, in that it helps them decide on a course of action depending on a list of variables. However, when a patient arrives in a radiology department the decisions have already been made by the provider. There's not much else anyone in the radiology department can do. To make things even more difficult, the ONC's testing criteria "Test Procedure for §170.314(a)(8) Clinical decision support" states over and over that each CDS intervention be automatic and based on the patient's problem, medication, medication allergy, demographics, labs, and vitals. Like I said, all of those variables have already been sorted out by the time a patient has arrived in the radiology department, so do you have any thoughts on how a radiologist can incorporate CDS?

I have to agree that the rules are more geared towards traditional providers.  I also seem to remember a few cases where there were exceptions available when a provider did not directly interact with a patient, but I don't believe that was addressed in CDS.  And while I could look it up, I'm on vacation ;-)

So let me see what you can do to help this reader.  Please respond in comments below.