Generating R-SCAN Reports
R-SCAN participants can generate baseline and post-education reports in one of three ways as described below. The method of choice should be based upon factors such as whether CareSelect Imaging clinical decision support has been implemented, the number of cases to be reviewed at baseline and post education (at least 25 for each phase is recommended) and whether the topic is a standard R-SCAN Choosing Wisely topic or a unique practice-defined topic.
1. Use of the R-SCAN Portal for Generating Case Review ReportsThis method of generating R-SCAN reports uses the browser-based CareSelect portal to enter each case manually. Once a practice has registered for a topic, participants will login to the R-SCAN Workspace, navigate to the “Enter Cases” page and then begin entering data by clicking “Enter baseline data” for their registered topic. After the baseline data and educational program are completed, post-education cases are entered in the same manner.
The CareSelect portal allows participants to enter each relevant case one at a time by selecting the age and gender of the patient, the body area or imaging modality, the clinical scenario and finally the type of imaging exam ordered for that case. The imaging exam and associated appropriateness rating is selected and added to the facility’s R-SCAN report by clicking “Select this exam” and then “Accept.”
For guidance, each registered topic on the “Enter Cases” page includes a description of the CareSelect “pathway” to help users select the correct clinical scenario for each topic. View detailed instructions for the R-SCAN case portal.
Benefits of Using the Portal: Easy-to-use and straightforward method of data entry, especially for practices working with a small baseline and post-education data sets of 25 to 50 cases each.
Considerations: May be burdensome for projects involving a large data set since cases must be entered one at a time.
2. Use of an Excel Report for Uploading Data and Generating Case Review Reports
Participants who wish to bulk-upload retrospective data can enter their cases into an Excel template that allows for recording all data for generating R-SCAN reports. A topic-specific template is available for each R-SCAN topic and can be created for practice-defined topics. Data are entered by selecting indications and exams from drop-down lists specific to the chosen topic and certain fields are autopopulated.
Benefits of Using the Excel Data Upload: Allows for easy importing of larger numbers of cases. Provides an opportunity to add an extra field for participants who wish to track more data than what is required for an R-SCAN project (e.g., exam positivity, referring physician’s name).
Considerations: Appropriateness ratings for each exam must be looked up in the Appropriateness Criteria Table available on the R-SCAN website.
3. Use of Clinical Decision Support Data for Generating Automated Case Review Reports
Facilities that have order entry systems with clinical decision support (CDS) integration such as CareSelect Imaging can create R-SCAN reports using their CDS data. In this scenario, case review is automated by using the data clinicians enter when ordering an exam.
The first step is to execute an agreement that allows CareSelect to send non-patient identifying data from the facility’s CDS database to the ACR. The facility’s CDS data are then mapped to the selected R-SCAN topic and associated indications to create baseline and post-education reports.
Benefits of Using CDS Data: Automating performance reports for the R-SCAN topics helps to quickly identify imaging areas and potential referring groups that could benefit from education about the ordering of value-added imaging for improved patient care. The need for individual case review is eliminated and a project can be completed in a matter of months with more focus on the educational component of the project.
Considerations: Practice must have CDS integrated into its ordering system in order to use this option, and the CDS R-SCAN project must select one of the existing R-SCAN topics. The opportunity to conduct a “practice-defined” R-SCAN topic is not currently available for CDS R-SCAN.