The healthcare industry is on an inexorable march toward complete digitization. There’s constant progress, though levels of digital success vary widely across organizations. In a lot of cases, a facility will commit to the minimum required to achieve the goal of digital patient management. For example, we have seen hospitals adopt what is known as a Computerized physician order entry (CPOE) system. CPOEs enable a doctor to place an order for a service like an X-Ray or a prescription using a computer interface. This is surely a great advance over phoned-in or faxed orders. However, it is now possible to take the concept of the CPOE to a new level of functionality, one that will improve patient care and hospital finances significantly in the process.
Introducing the Guided Intelligence Protocol
CPOEs can schedule order requests. However, this is a one-dimensional approach to scheduling. Given today’s competitiveness in healthcare, hospitals should seek to secure every possible advantage where patient care, physician loyalty and the revenue cycle are concerned. “Guided Intelligence Protocol” (GIP) offers a three-dimensional way forward.
A GIP solution, such as iOrder, includes more features than placing the order request itself. A GIP solution demands compliance with qCDSM. It also enables transparency for referring physicians as well as proper information and use of CPT codes to drive the revenue cycle. It offers intelligence-based decision support.
A GIP solution directs the user to next steps in the ordering process based on the answers to questions about the order. Questions may be related to an order stoppage, pre-elective medication or additional labs or studies that need to be performed. This intelligent workflow could reveal conflicts that might affect patient health and/or create unnecessary paperwork, service reviews and delay reimbursements.
For example, imagine that a doctor wants to order a CT scan. The GIP system asks if the patient is allergic to IV contrast. In this scenario, iOrder would recommend a series of best practices for prepping the patient for the CT. The system directs clinical decision on what premedication protocol is selected. Or, it could suggest ordering an exam without contrast. These are only recommendations. The physician is still in control. But, with guided intelligence, that practitioner can be more fully informed of the potential consequences for the patient’s care.
GIP vs. CPOE
iOrder, representing the three-dimensional GIP approach to order management, differs in the following ways from off the shelf CPOE systems:
- Adds a site’s available exams to the exam selection menu
- Contains vetting questions that are necessary to order and perform exams safely (iOrder vetting questions are referenced, typically with American College of Radiology recommendations)
- Provides suggestions for necessary indications, such as when a serum creatinine is needed and a suggested safe value
- Indicates when a screening mammogram should be ordered versus a diagnostic
- Offers a simple method to indicate the area of patient or physician concern in the breast
- Requires a simple, quick history of significant past or current medical issues such as a history of a specific cancer
- Requires a specific, reimbursable exam reason. (E.g. No more total body CT scans to “assess treatment, weakness, etc.”
- Requires the situs of the disease to be indicated or the exam is rendered unreimbursable (E.g. CT for breast cancer. The situs must be given—left or right)
- Features design and functionality created with maximum input from hospital CEOs, CFOs, COOs, radiology technologists, lab technologists, dieticians, physical therapists, radiologists, clinicians, central schedulers and nurses
- Provides detailed, written instructions for the exam that are given to the patient at the time of the clinician’s visit
- Eliminates phone calls to central scheduling to schedule an exam
- Notifies the ordering clinician of the exam’s results or if the patient did not show up for the exam. (The latter prevents a patient from returning to the clinician’s office months later in much worse condition because the patient did not show up for the exam.)
- Includes an afterhours phone number for phone calls to the ordering clinician so that patients do not have to be referred to the Emergency Department because the clinician on call cannot be located
- Provides direction to the site of the exam
- Allows a clinician’s logo to be added to the patient’s instruction sheet
- Allows for text notifications to the patient as a reminder of exam time
- Differentiates between registration time and exam time
- Provides a link to an American College of Radiology web site that explains the exam
- Provides a phone number on the exam instruction sheet to call to cancel the exam and to report complications post exam
iOrder leverages the GIP concept to ensure better patient care, help a facility boost profits, and contribute to more positive, profitable relationships with referring physicians. To learn about iOrder, visit http://iprohealthcare.com/
