Encounter-based vs. order-based imaging

by Sean Ruck, Contributing Editor | April 10, 2018
Health IT
From the April 2018 issue of HealthCare Business News magazine


In order to have information associated with the image, that information needs to be manually entered. And manual entry is synonymous with bottlenecked workflow in many cases. Or worse, the manual entry just doesn’t happen.

“If you take a point-of-care ultrasound,” for as another example, “you have specialists running around, starting their scan. In some cases, you need to have those images retained in order to have them reimbursed, but the only thing you might need to do in your clinical note is give some indication that the imaging was done. You don’t necessarily need to place an order as a physician.

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“If you’re going and seeing patients and need a quick ultrasound on someone’s port, for example, you’re not going to turn around and find the nearest computer to place an order. You’re just going to get enter the patient’s information and start scanning them. And the idea behind encounter-based imaging is that you no longer have to place an order to be able to find that patient on thea patient schedule on an imaging device, and you no longer have to place an order to obtain information to secure the appropriate clinical information and associate it within the metadata of that image in order to index those images properly in an archive.”

And indexing is all-important since proper indexing is followed by efficient distribution of those images. So, for example, if it’s only known that an ultrasound was done due to very generic and top-level documentation, will the time be spent to see if it’s the abdomen ultrasound you need, or do you just go right to it rather than potentially wasting time looking for an image that might not exist? With encounter-based workflows, however, relativity can be established.

Another example would be a dermatology patient. On a previous visit, the patient had images taken of three moles. Six months later, the patient returns with concerns that one of the moles has changed. If the indexing was done, the physician can pull up “left forearm mole” to do the comparison. Or, they search through a number of images and hope that the one they need actually exists.

So encounter-based imaging can provide benefits to the patient. But what about the physicians?

“At a previous organization, we noted an 82 percent increase in physician satisfaction with encounter-based imaging in dermatology. We went from an over five-minute average time to find prior images and view them to less than 30 seconds. So there was a really significant decrease in the time it took to find the exams,” said Cram.

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