by
Astrid Fiano, DOTmed News Writer | August 10, 2010
That effectiveness may be determined in the results of the peer comparison aspect. For the clinicians, Cowsill says, "it's all about the data. It's one thing to say to a clinician that you are ordering a lot more than your colleague down the street. But if I can show what the ordering patterns are compared to others, I think that clinicians can really respond to that data. And not only to data, but also to education."
Many clinicians, he says, particularly primary care physicians, are very interested in new ways to help make quality decisions for the patient. In explaining the benefits of e-CDS, that means comparing the difference between e-CDS and RBMs. Cowsill says the calls to an RBM to get an approval or denial can take several minutes or even hours. "What we have done is take that out of the picture and made it electronic. The clinicians can take the case to the internet and run through the clinical application." With Nuance, for example, the RadPort™ system brings back a set of scaled answers as to whether an imaging option is of marginal utility, or if the system has a better option. The process takes place within seconds, Cowsill explains, and is better integrated into the CPOE workflow in a hospital.
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Cowsill comments that the Coalition had proposed to CMS contextualizing the peer comparison aspect in terms of results. In other words, telling the clinician, "Here's what everyone else is ordering and here are the actual outcomes of the studies you have ordered." There is no definitive word as to whether CMS has accepted that idea, but to do so would further the project, Cowsill feels. To have not just the comparison of numbers, but knowing the outcomes of those numbers.
"We are all dealing from the same clinical medical evidence," he remarks. "So the interest is in getting more data so we can make the clinical guidelines we currently have that much better. Everyone is interested in that: vendors, the Coalition, the ACR, the ACC. There is a huge value in the project."
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