confidential and proprietary information – do not circulate
note: CDS alert displays using Epic’s native best practice alerts;
Epic does not allow use of actual screenshots
Choosing Wisely: Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.(American Geriatrics Society)1, 2, 3
Reasons for override:sleep disorder end of life care withdrawal / DT
non-drug options failed
peri-procedural anesthesia
physician starts order
in EMR
likely appropriat
e
targeted alerts integrated into workflow
order placed
order cancelled
likely unnecessary
✓
✕
Hyperlink: Choosing Wisely – American Geriatrics SocietyInformation for Patients: Use of Sedatives in Elderly Patients
confidential and proprietary information – do not circulate
predictor of success adjusted OR
automatic provision of decision support as part of workflow
112
provision of decision support at the time and location of decision making
15
provision of recommendation rather than just an assessment
7
computer-based generation of decision support
6
75% of decision support interventions succeed when the information is provided to clinicians automatically, whereas none succeed when clinicians are required to seek out the advice decision support
is most effective at the point of
careSource: Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice
using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005 Apr 2;330(74794):765 . PMID: 15767266
confidential and proprietary information – do not circulate
provider notification (BPA)
hospital staff(c-suite, medical
directors, analytics, providers)
standard Epic import
analyticsengine
nightly secure FTP feed from Clarity1
display of order and alert firing information, including provider
response
initial implementation !
note: CDS alert displays using Epic’s native best practice alerts (BPA); Epic does not allow use of actual screenshots
how is the solution delivered?
1. includes order data and each instance of BPA firing with provider name and response
SQL scripts for Clarity
confidential and proprietary information – do not circulate
opportunity dashboard
helps identify savings opportunities associated with various alerts
confidential and proprietary information – do not circulate
outlier dashboard
identifies providers with the largest deviation from standard practice based on their alerting and ordering patterns
confidential and proprietary information – do not circulate
provider activity
provides a detailed breakdown of provider’s ordering and alerting activity
confidential and proprietary information – do not circulate
activity dashboard
provides an operational overview of alert and provider activity
confidential and proprietary information – do not circulate
high cost labs
high cost pro-cedures
high cost med-ications
CT and MRI imaging
nuclear imaging
our content lowers
waste & cost
confidential and proprietary information – do not circulate
Protecting Access to Medicare Act of 2014 (PAMA) is signed, with section 218 of H.R. 4302 outlining the Radiology CDS requirements
March 31, 2014
CMS begins data collection period for identification of “outlier” ordering providers with low AUC adherence rates relative to their peers
January 1, 2018
CMS will no longer reimburse providers ordering advance diagnostic imaging exams unless the provider consults an appropriate use criteria (AUC) prior to ordering
January 1, 2017
Ordering Providers that CMS has identified as “outliers” will be required to obtain prior-authorization
January 1, 2020
Stanson will provide content that satisfies the requirements of the legislation with the same
methodology, integration, and “look and feel” as non-imaging related content
confidential and proprietary information – do not circulate
mean
2 SD
2 SD
date most alerts deployed
significantly reducedtargeted imaging tests
confidential and proprietary information – do not circulate
Value Improvement Predictor (VIP) Program – FREE 90 Day Trial
Choosing Wisely BPAs deployed silently
full access to Stanson analytics
customized savings analysis 
Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.
Don’t screen for carotid artery stenosis (CAS) in asymptomatic adult patients.
Avoid nonsteroidal anti-inflammatory drugs (NSAIDS) in individuals with hypertension or heart failure or CKD of all causes, including diabetes.
Don’t do imaging for low back pain within the first six weeks, unless red flags are present.
Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms of active coronary disease, heart failure or stroke.
included recommendations
confidential and proprietary information – do not circulate
Value Improvement Predictor (VIP) Program – FREE 90 Day Trial
Choosing Wisely BPAs deployed silently
full access to Stanson analytics
customized savings analysis 
Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.
Don’t screen for carotid artery stenosis (CAS) in asymptomatic adult patients.
Avoid nonsteroidal anti-inflammatory drugs (NSAIDS) in individuals with hypertension or heart failure or CKD of all causes, including diabetes.
Don’t do imaging for low back pain within the first six weeks, unless red flags are present.
Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms of active coronary disease, heart failure or stroke.
included recommendations