Appropriate Use

Get ready! On January 1, 2020 all providers in the US will be required by CMS under the Protecting Access to Medicare Act of 2014 (PAMA) to ensure that radiology orders have been validated electronically through the use of an electronic clinical decision support mechanism (CDSM). LogicNets is a CMS-qualified CDSM provider. We have partnered with qualified provider-led entities (qPLEs) authorized by CMS to provide the mandatory clinical guidelines under PAMA. Our powerful Clinical Decision Support platform allows Providers, PLEs and EMR vendors to develop robust appropriate use validation capabilities and comply with the new requirements.

A Unique AUC Platform

Appropriate use guidance for most radiology orders should be a silent failsafe that doesn’t complicate workflow. LogicNets AUC is a software service that can be accessed remotely or deployed on-prem. It integrates with the workflow to receive order requests and, in the background, it identifies the applicable electronic guideline and uses the information in the patient record to navigate that algorithm to generate a conclusion – appropriate, inappropriate, not enough information, no matching guideline. If the order is appropriate, the system enables the order with no interaction required from the user.

If there is an issue, the system allows the clinician to see a visual representation of the decision pathway and prompts the user for missing information or provides appropriate alternative order options. With a single click the system can transition from a silent background process to a wealth of information allowing users to visually navigate decision pathways and dynamically access reference information including evidence and learning aids.

Priority Areas

The AUC guidelines we use are from leading Qualified Provider-Led Entities (qPLEs) including Intermountain Health, National Comprehensive Cancer Network (NCCN), and the American College of Cardiology (ACC). We plan on adding content from additional PLEs enabling content expansion to meet demand from other specialties.

LogicNets provides AUC content for all priority clinical areas set by CMS including:

Hip pain
Low back pain
Cervical or neck pain
Suspected pulmonary embolism
Headache

Traumatic and nontraumatic

Coronary artery disease

Suspected or diagnosed

Shoulder pain

Includes suspected rotator cuff injury

Cancer of the lung

Primary or metastatic, suspected or diagnosed

Institutions and Clinicians

LogicNets AUC is not simply a scenario-based look-up table for catching bad orders. It takes a diagnostic approach to assess the patient’s overall condition and indicates the most appropriate imaging tests based on the patient’s condition. This allows it to screen for mistakes, but also provide intelligent guidance. Ordering physicians access the LogicNets AUC function seamlessly from within their workflow through tight integration with the EMR. Yet you can also access the application’s order validation portal without an EMR and interact with the system to identify, prompt and run relevant guidelines. Benefits include:

  • Streamlines and directs the clinician to the most applicable Appropriate Use Criteria.
  • Provides rapid and unobtrusive validation
  • Provides contextual real-time access to interactive AUCs, background information, clinical evidence, and other aids
  • Generates all CMS-prescribed reports for the organization and individual clinicians to demonstrate compliance and support audits
  • Integrates seamlessly into the EMR and clinical workflow.
  • Stand-alone Portal for clinicians that do not have EMRs or do not desire an integrated solution.

Qualified Provider Led Entities

The LogicNets AUC solution is powered by our unique visual design platform and content management repository, ideal for organizations creating and curating appropriate use criteria and guidelines. Many of the organizations that have been authorized to develop AUC guidelines are not experienced in developing and maintaining commercial or externally used content products. The LogicNets platform enables rapid, efficient, and tightly controlled capture of AUC content in an executable format optimized for automation by any CDSM (including the LogicNets CDSM service). The platform can also be used to automate a structured workflow for managing the collaboration of the AUC content development and review teams. This platform is capable of automating and managing the often-challenging task of supporting large amounts of clinical evidence and keeping it and the AUC content it influences up-to-date. Finally, LogicNets’ ability to span the ongoing creation and maintenance of AUC content with its actual delivery and consumption in the field makes it possible for AUC content originators to quantitatively measure the impact of their criteria on clinical use.

The LogicNets designer platform in conjunction with our AUC delivery module provides an unmatched platform for qPLEs to rapidly create and efficiently delivery their electronic AUC guidelines:

  • Minimizes time-to-market by enabling rapid modeling content and automating protocols in a matter of minutes or hours.
  • Delivers consumable AUC content for decision-based applications to CDSMs.
  • Efficiently integrates AUC guidelines into the workflow.
  • Simplifies long-term maintenance and enables virtually real-time updates of AUC criteria.
  • Supports standard web services-based interoperability protocols to securely gain access to EHR data, drive workflow decision-making and populate the patient record with the results.
  • Supports the most commonly used healthcare protocols from simple HL7 to OpenCDS, including SMART on FHIR and CDS hooks.

EHR and RIS Vendors

LogicNets’ technology provides a solution with integration capabilities from simple HL7 to OpenCDS that will help your system comply with AUC mandates. We see a clear industry adoption trend for EHR and RIS systems focusing future Appropriate Use Criteria Clinical Decision Support heading towards SMART on FHIR and utilizing CDS Hooks as their strategic approach towards interoperability with external decision support mechanisms. Benefits include:

  • LogicNets forward-looking technology provides HL7v2, HL7v3, SMART on FHIR, CDS Hooks, etc.
  • Appropriate Use Criteria in integrated and embedded in clinician’s workflow providing ordering professionals recommendations with minimal disruption.
  • Multiple CDS integration points in EHR or RIS that enables users to easily identify the most appropriate AUC and take appropriate action.
  • LogicNets provides you with an Integration Sandbox that allows your solution to test the most optimal integration points and systems synergy.