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Kevin Yuqi Wang - One of the best experts on this subject based on the ideXlab platform.
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Radiology Support, Communication, and Alignment Network and Its Role to Promote Health Equity in the Delivery of Radiology Care.
Journal of the American College of Radiology, 2019Co-Authors: Kevin Yuqi Wang, Christie M. Lincoln, Melissa M. ChenAbstract:Abstract Racial, ethnic, and socioeconomic disparities in radiological care have been well documented in both the emergency and outpatient setting. Health IT has the potential to facilitate equitable care across diverse populations. Ordering the appropriate study is the first step in the greater mission of improving access and equity for everyone. Radiology Support, Communication, and Alignment Network (R-SCAN) is an informatics-based solution using clinical decision Support (CDS) to promote health equity through optimization in appropriate imaging utilization. R-SCAN and CDS may help combat the potential implicit bias of clinicians by providing evidence-based imaging guidelines at the point of care and ensure that patients will receive equitable and appropriate imaging regardless of ethnic and socioeconomic background. By fostering multidisciplinary collaboration between radiologists and referring clinicians, R-SCAN initiatives across the nation have demonstrated successful reductions in inappropriate imaging utilization, particularly in regions with vulnerable populations.
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Reducing Inappropriate Lumbar Spine MRI for Low Back Pain: Radiology Support, Communication and Alignment Network
Journal of the American College of Radiology, 2018Co-Authors: Kevin Yuqi Wang, Melissa M. Chen, Christopher James Yen, Darshan Variyam, Tomas Uribe Acosta, Max Wintermark, Brian C. Reed, Christie M. LincolnAbstract:Abstract Purpose The aim of this study is to evaluate the impact of educational sessions on reducing lumbar spine MRI inappropriateness for uncomplicated low back pain and to present our institutional experience on the use of ACR's Radiology Support, Communication and Alignment Network (R-SCAN) program toward achieving appropriateness. Methods The R-SCAN web portal was accessed to register a project. Using order entry data, the number of lumbar spine MRI orders placed per month at three family medicine clinics was assessed over a 10-month period. After educational presentations were given at those three clinics highlighting the American College of Physicians and Choosing Wisely campaign imaging guidelines, the number of MRI orders placed was reassessed over an additional 10 months. For a subset of these exams, the ACR Appropriateness Criteria rating of the lumbar spine MRIs were compared between the pre- and posteducation periods. A P value Results The average number of monthly MRIs ordered from all three clinics combined was 6.3 during the posteducation period, which was significantly less than during the pre-education period of 10.0 ( P = .009). The combined average ACR Appropriateness Criteria rating made at all three clinics was 5.8 after educational sessions, which was significantly higher than the rating of 4.7 before educational sessions ( P = .014). Conclusion Clinician education, facilitated by R-SCAN, resulted in a reduced number of MRI lumbar spine studies performed for uncomplicated low back pain and improved appropriateness of those studies as measured by the ACR Appropriateness Criteria rating.
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Reducing Inappropriate Lumbar Spine MRI for Low Back Pain: Radiology Support, Communication and Alignment Network.
Journal of the American College of Radiology : JACR, 2017Co-Authors: Kevin Yuqi Wang, Christopher James Yen, Melissa Chen, Darshan Variyam, Tomas Uribe Acosta, Brian Reed, Max Wintermark, Christie Mary LincolnAbstract:The aim of this study is to evaluate the impact of educational sessions on reducing lumbar spine MRI inappropriateness for uncomplicated low back pain and to present our institutional experience on the use of ACR's Radiology Support, Communication and Alignment Network (R-SCAN) program toward achieving appropriateness. The R-SCAN web portal was accessed to register a project. Using order entry data, the number of lumbar spine MRI orders placed per month at three family medicine clinics was assessed over a 10-month period. After educational presentations were given at those three clinics highlighting the American College of Physicians and Choosing Wisely campaign imaging guidelines, the number of MRI orders placed was reassessed over an additional 10 months. For a subset of these exams, the ACR Appropriateness Criteria rating of the lumbar spine MRIs were compared between the pre- and posteducation periods. A P value < .05 was considered statistically significant. The average number of monthly MRIs ordered from all three clinics combined was 6.3 during the posteducation period, which was significantly less than during the pre-education period of 10.0 (P = .009). The combined average ACR Appropriateness Criteria rating made at all three clinics was 5.8 after educational sessions, which was significantly higher than the rating of 4.7 before educational sessions (P = .014). Clinician education, facilitated by R-SCAN, resulted in a reduced number of MRI lumbar spine studies performed for uncomplicated low back pain and improved appropriateness of those studies as measured by the ACR Appropriateness Criteria rating. Copyright © 2017 American College of Radiology. All rights reserved.
Christie M. Lincoln - One of the best experts on this subject based on the ideXlab platform.
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Assessment of the Radiology Support, Communication and Alignment Network to Reduce Medical Imaging Overutilization: A Multipractice Cohort Study.
Journal of the American College of Radiology, 2020Co-Authors: Paymon Rezaii, Christie M. Lincoln, Nancy Fredericks, Jason Hom, Marc H. Willis, Judy Burleson, G. Rebecca Haines, Mythreyi B. Chatfield, Derek B. Boothroyd, Victoria Y. DingAbstract:Abstract Purpose The aim of this study was to determine whether participation in Radiology Support, Communication and Alignment Network (R-SCAN) results in a reduction of inappropriate imaging in a wide range of real-world clinical environments. Methods This quality improvement study used imaging data from 27 US academic and private practices that completed R-SCAN projects between January 25, 2015, and August 8, 2018. Each project consisted of baseline, educational (intervention), and posteducational phases. Baseline and posteducational imaging cases were rated as high, medium, or low value on the basis of validated ACR Appropriateness Criteria®. Four cohorts were generated: a comprehensive cohort that included all eligible practices and three topic-specific cohorts that included practices that completed projects of specific Choosing Wisely topics (pulmonary embolism, adnexal cyst, and low back pain). Changes in the proportion of high-value cases after R-SCAN intervention were assessed for each cohort using generalized estimating equation logistic regression, and changes in the number of low-value cases were analyzed using Poisson regression. Results Use of R-SCAN in the comprehensive cohort resulted in a greater proportion of high-value imaging cases (from 57% to 79%; odds ratio, 2.69; 95% confidence interval, 1.50-4.86; P = .001) and 345 fewer low-value cases after intervention (incidence rate ratio, 0.45; 95% confidence interval, 0.29-0.70; P Conclusions R-SCAN participation was associated with a reduced likelihood of inappropriate imaging and is thus a promising tool to enhance the quality of patient care and promote wise use of health care resources.
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Radiology Support, Communication, and Alignment Network and Its Role to Promote Health Equity in the Delivery of Radiology Care.
Journal of the American College of Radiology, 2019Co-Authors: Kevin Yuqi Wang, Christie M. Lincoln, Melissa M. ChenAbstract:Abstract Racial, ethnic, and socioeconomic disparities in radiological care have been well documented in both the emergency and outpatient setting. Health IT has the potential to facilitate equitable care across diverse populations. Ordering the appropriate study is the first step in the greater mission of improving access and equity for everyone. Radiology Support, Communication, and Alignment Network (R-SCAN) is an informatics-based solution using clinical decision Support (CDS) to promote health equity through optimization in appropriate imaging utilization. R-SCAN and CDS may help combat the potential implicit bias of clinicians by providing evidence-based imaging guidelines at the point of care and ensure that patients will receive equitable and appropriate imaging regardless of ethnic and socioeconomic background. By fostering multidisciplinary collaboration between radiologists and referring clinicians, R-SCAN initiatives across the nation have demonstrated successful reductions in inappropriate imaging utilization, particularly in regions with vulnerable populations.
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Reducing Inappropriate Lumbar Spine MRI for Low Back Pain: Radiology Support, Communication and Alignment Network
Journal of the American College of Radiology, 2018Co-Authors: Kevin Yuqi Wang, Melissa M. Chen, Christopher James Yen, Darshan Variyam, Tomas Uribe Acosta, Max Wintermark, Brian C. Reed, Christie M. LincolnAbstract:Abstract Purpose The aim of this study is to evaluate the impact of educational sessions on reducing lumbar spine MRI inappropriateness for uncomplicated low back pain and to present our institutional experience on the use of ACR's Radiology Support, Communication and Alignment Network (R-SCAN) program toward achieving appropriateness. Methods The R-SCAN web portal was accessed to register a project. Using order entry data, the number of lumbar spine MRI orders placed per month at three family medicine clinics was assessed over a 10-month period. After educational presentations were given at those three clinics highlighting the American College of Physicians and Choosing Wisely campaign imaging guidelines, the number of MRI orders placed was reassessed over an additional 10 months. For a subset of these exams, the ACR Appropriateness Criteria rating of the lumbar spine MRIs were compared between the pre- and posteducation periods. A P value Results The average number of monthly MRIs ordered from all three clinics combined was 6.3 during the posteducation period, which was significantly less than during the pre-education period of 10.0 ( P = .009). The combined average ACR Appropriateness Criteria rating made at all three clinics was 5.8 after educational sessions, which was significantly higher than the rating of 4.7 before educational sessions ( P = .014). Conclusion Clinician education, facilitated by R-SCAN, resulted in a reduced number of MRI lumbar spine studies performed for uncomplicated low back pain and improved appropriateness of those studies as measured by the ACR Appropriateness Criteria rating.
James Sorce - One of the best experts on this subject based on the ideXlab platform.
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use of a visual graphic language system to Support Communication for persons on the autism spectrum
Perspectives on Augmentative and Alternative Communication, 2009Co-Authors: Howard C Shane, Meghan Obrien, James SorceAbstract:This paper addresses use of visual graphic language to promote learning and Communication for individuals on the autism spectrum via a comprehensive framework. Specifically, visuals are used expres...
Lyndal Bugeja - One of the best experts on this subject based on the ideXlab platform.
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managing risk for aging patients in long term care a narrative review of practices to Support Communication documentation and safe patient care practices
Risk Management and Healthcare Policy, 2019Co-Authors: Joseph E Ibrahim, Alice L Holmes, Carmel Young, Lyndal BugejaAbstract:: Resident safety and welfare in long-term care (LTC) is being redefined as the focus shifts to promoting an optimal quality of life especially in LTC. Achieving this requires contemporary practice to improve the organization and staff's ability in identifying, communicating, documenting, and managing the risks that arise from the choices a person makes in pursuit of a better quality of life. This article is a narrative realist style review examining the issues of how to manage risks for older residents living in LTC. The issues are examined in six stages: context, identifying, communicating, documenting, enacting, reviewing and reflecting on how choices are made and risks managed. It is important for individuals to be Supported in making an informed choice - this requires identifying, providing, and communicating the available options and the potential consequences. Documenting consent, perhaps with formal risk agreements, provides clarity for all involved and assists in determining how and who is responsible for enacting choices. Reviewing and reflecting upon the decisions and actions to enact choices are familiar to prudent LTC managers who implement and monitor robust governance systems. Learning from these experiences is essential to better meet individual resident, staff, organizational, and community expectations. Improving practice at each of the six steps should reduce adverse professional and legal repercussions and enable the resident, families, and staff to better cope with respecting choices when a known harmful outcome eventuates.
Yan Xiao - One of the best experts on this subject based on the ideXlab platform.
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user designed information tools to Support Communication and care coordination in a trauma hospital
Journal of Biomedical Informatics, 2009Co-Authors: Ayse P Gurses, Yan XiaoAbstract:Background: In response to inherent inadequacies in health information technologies, clinicians create their own tools for managing their information needs. Little is known about these clinician-designed information tools. With greater appreciation for why clinicians resort to these tools, health information technology designers can develop systems that better meet clinicians' needs and that can also Support clinicians in design and use of their own information tools. Objective: To describe the design characteristics and use of a clinician-designed information tool in Supporting information transfer and care coordination Design: Observations, semi-structured interviews, and photographing were used to collect data. Participants were six nurse coordinators in a high-volume trauma hospital. Content analysis was carried out and interactions with information tools were analyzed. Results: Nurse coordinators used a paper-based information tool (a nurse coordinator's clipboard) that consisted of the compilation of essential data from disparate information sources. The tool was assembled twice daily through (1) selecting and formatting key data from multiple information systems (such as the unit census and the EHR), (2) data reduction (e.g., by cutting and whitening out non-essential items from the print-outs of computerized information systems), (3) bundling (e.g., organizing pieces of information and taping them to each other), and (4) annotating (e.g., through the use of colored highlighters and shorthand symbols). It took nurse coordinators an average of 41min to assemble the clipboard. The design goals articulated by nurse coordinators to fit the tool into their tasks included (1) making information compatible with the mobile nature of their work, (2) enabling rapid information access and note-taking under time pressure, and (3) Supporting rapid information processing and attention management through the effective use of layout design, shorthand symbols, and color-coding. Conclusions: Clinicians design their own information tools based on the existing health information technologies to meet their information needs. The characteristics of these clinician-designed tools provide insights into the ''realities'' of how clinicians work with health information technologies. The findings suggest an often overlooked role for health information technologies: facilitating user creation of information tools that will best meet their needs.
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A computing platform to Support Communication and sense-making in intensive care.
AMIA ... Annual Symposium proceedings. AMIA Symposium, 2007Co-Authors: Yan Xiao, Vaidya, Seebode S, Cardarelli MAbstract:We developed a conceptual design of a mobile computing platform to Support multi-disciplinary rounds in intensive care units.
