Latest eStar updates and changes announced

Indication Groups when Ordering Advanced Imaging Exams

Beginning Nov. 13, there will be three main Indication groups from which to choose the “Reason for Exam” when ordering CT, MR, PET and NM exams. These Indication Groups are:

• Common Indications
• Oncology Indications
• Trauma Indications

Common Indications are the most commonly used indications nationally and will now be expanded by default for easier access. The “Other” Indications group is now gone. Depending on the specific radiology order placed, clinicians may see other indication groups/options such as Cardiology.

The indication groups are to improve efficiency. You can also easily search for other indications in the Reason for Exam field.

These Indication Groups are a first step in preparing clinicians for clinical decision support coming in early 2020. The Protecting Access to Medicare Act (PAMA) goes live on Jan 2, 2020, and requires that physicians ordering advanced imaging exams consult Appropriate Use Criteria (AUC) through a qualified Clinical Decision Support Mechanism (qCDSM).

For more information, please see the Tip Sheet “Improving Imaging Orders - Reason for Exam” (available in Hubbl).

Review of Systems (ROS) Documentation

Beginning Nov. 13, a new SmartList will be added to all Navigator Review of Systems (ROS) note templates. This change is to ensure compliance with a new VUMC policy based on recent CMS guidance that states clinicians must now review 10 of 14 available systems.

A “comprehensive” ROS is required for anything other than lowest level history and physical (H&P) or new consult. The new SmartList (VUMC IP ROS 14 System List) will be added to all Navigator ROS note templates, or an updated list already on the note template to include all 14 systems

Individual systems that need review may be selected as needed, along with “All other systems were reviewed and are negative.”

Clinicians may no longer simply list the number of systems reviewed without being specific. Therefore, it is not compliant to document “10 systems reviewed and were negative except as per the HPI”. If all 14 systems not reviewed, the clinician must individually list systems reviewed with pertinent positives / negatives. 

Clinicians should update templates/smart phrases to ensure compliance.