At Stanson Health we work with Epic customers by offering pre-built evidence based guidelines that fire at the time of order entry based primarily on Choosing Wisely and PQRS guidelines (200+). We currently have over 100 imaging alerts already built that will comply with the upcoming requirements.

1. 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
appropriate
targeted alerts integrated into workflow
order
placed
order
cancelled
likely
unnecessary
✓
✕
Hyperlink: Choosing Wisely – American Geriatrics Society
Information for Patients: Use of Sedatives in Elderly Patients

2. 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 care
Source: 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

3. confidential and proprietary information – do not circulate
provider notification (BPA)
hospital staff
(c-suite, medical
directors, analytics,
providers)
standard
Epic import
analytics
engine
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

4. confidential and proprietary information – do not circulate
opportunity
dashboard
helps identify savings opportunities
associated with various alerts

5. 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

6. confidential and proprietary information – do not circulate
provider
activity
provides a detailed breakdown of
provider’s ordering and alerting
activity

7. confidential and proprietary information – do not circulate
activity
dashboard
provides an operational overview of
alert and provider activity

8. confidential and proprietary information – do not circulate
high cost
labs
high cost
procedures
high cost
medications
CT and MRI
imaging
nuclear
imaging
our content
lowers
waste & cost

9. 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

10. confidential and proprietary information – do not circulate
mean
2 SD
2 SD
date most
alerts
deployed
significantly
reduced
targeted
imaging tests

11. 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

12. 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