The LogicNets AUC Solution is a powerful CMS-qualified Clinical Decision Support Mechanism (“CDSM”) designed to help your organization meet the Jan 1, 2022 PAMA legal mandate of electronic appropriate use validation for all advanced imaging orders. Our solution uses an unmatched diagnostics-driven approach for validating and finding appropriate imaging services. With its advanced informatics, the AUC Solution can be rapidly and seamlessly integrated into workflow. Yet, we also provide a stand-alone visual portal to enable use outside the EMR. The service can be licensed on a transaction basis and it is remarkably easy to make available to your staff and systems for rapid deployment and immediate results.
With LogicNets, AUC validation is not only easy to implement, it actually enhances the collaborative workflow between ordering professionals and imaging service providers.
For ordering professionals — the LogicNets AUC Solution quickly generates the unique consultation identifier (UCI) you need to place orders and ensure reimbursement for the patient. It also gives you a clear and meaningful diagnostic view of the AUC process, rather than a payment-oriented set of look-up tables. With a unique graphical approach, the AUC Solution shows you the most appropriate ordering option and also identifies the best alternatives.
For furnishing professionals — the LogicNets AUC Solution not only helps ensure that you’ll get CMS reimbursement, but it gives a consistently clear understanding of why patients have been prescribed the ordered service. Gone are the days where you need to call the referrer’s office to clarify unclear information. The complete diagnostic pathway specified by the ordering physician is available to you on-screen, on-demand, giving you immediate insight.
LogicNets has teamed with the CMS-qualified provider-led entities (qPLEs) Intermountain Healthcare and NCCN to make their evidence-based Appropriate Use Criteria (AUC) available on demand electronically through our solution.
Our users find the resulting diagnostic approach to AUC as rendered in the LogicNets CDSM more clinically meaningful than traditional scenario look-up tables.
LogicNets uniquely renders and manages the AUC as visual decision pathways that users can interact with graphically. Clinicians favor this approach because it makes the AUC approval logic clear and, as a result, they trust the recommendations. Visualizing the diagnostic pathway also makes it easy to recognize and deal with edge cases and identify alternative appropriate imaging services.
The LogicNets AUC Solution is a modular web-based technology. It integrates into the workflow via secure web services and users can interact with it through their web-browsers.
The AUC Criteria contain the decision logic for each priority clinical area and are dynamically selected and processed by the CDSM Service during each AUC consultation.
The CDSM Service processes consultations and retains records for reporting and analytics via the Reporting Module. It intelligently toggles between “silent mode” in the background and LogicNets’ distinctive visual pathways interface.
External applications – such as the EMR or RIS — integrate with the CDSM Service via standard web services calls using a CDS Hooks and FHIR-based method. LogicNets provides an online integration sandbox to make testing your integration quick and easy.
If a referring physician does not have an automated means to validate an order, the LogicNets AUC Portal application provides an alternative easy-to-use means of selecting patient scenarios, submitting consultations, and gaining immediate access to the results.
The LogicNets CDSM Service is available as a generic web service and can be securely accessed over the network by any application, using a standard CDS Hooks/FHIR-based integration method.
EMR, RIS, and other clinical workflow systems can prompt their users for patient scenario and desired order information and then pass that information to the LogicNets CDSM Service via this API to process a consultation using any common informatics coding system. The LogicNets integration sandbox makes your testing of this API and your particular informatics approach quick, easy, and flexible
The CDSM Service takes as input the details of a patient scenario, identifies the applicable AUC Content, and navigates through the conditional decision pathways of the guideline to arrive at appropriate order decision pathway endpoints. Having processed the input, the CDSM Service sends a results data package back to the requesting system, containing the validation outcome, the unique consultation identifier, and a wide range of information including all mandatory elements required for PAMA compliance.
The CDSM Service includes a powerful and flexible informatics management layer that allows consultations to process the informatics systems in use by your organization.
AUC consultations can be initiated with all patient scenario data submitted to the CDSM Service via the web services interface (“silent mode”). Or they can be initiated and run manually by an interactive user (“interactive” mode). In the interactive mode, the CDSM Service generates a web page with a graphical and interactive view of the decision pathways, allowing users to interact with graphical representations of the AUC and select and confirm on-screen the patient scenario factors that lead to the appropriate advanced imaging order options.
Silent and Interactive modes can work in tandem. For instance, if the consultation result is “not appropriate” or if the service is called with either no patient data or is incomplete and a result of “insufficient-patient-data” is returned, the ordering professional has the option to toggle on the interactive visual interface and provide additional information or investigate what orders are appropriate given the patient scenario.
Most imaging orders are still made outside of the EMR. LogicNets’ interactive AUC Portal is an intuitive alternative when an EMR is not available. It lets the ordering professional indicate the patient scenario and the advanced imaging order they wish to validate. It then calls the LogicNets CDSM Service to process that information.
The AUC Portal communicates with the CDSM Service to determine both if an applicable AUC guideline exists for the order and if the order is applicable for the selected patient scenario. The AUC Portal runs the CDSM Service in interactive mode so that the user can provide the required patient data and navigate the AUC Guideline visual pathways to the correct result. Once the user has identified and selected the desired order, the system displays the corresponding results data package for the user to copy the Unique Consultation ID (or “Decision Support Number”), applicable CMS modifiers and codes, and any other details into the ordering system.
The AUC Portal also uses heuristic learning-based AI to provide users powerful shortcuts for validating their most frequently recommended orders, rapidly confirming a scenario and processing the order in just two clicks.
With LogicNets AUC Reporting, ordering professionals and their organizations can generate informative graphical reports regarding usage of the AUC Solution. The CDSM Service retains the results for all consultations it processes. The AUC Reporting application aggregates this data and allows users to analyze their usage of the system, using the interactive report builder to filter across a range of factors and format output in tabular and graphical formats.
Most important, these reports help ordering professionals prove compliance with PAMA by indicating the number of consultations processed under their individual NPI during each annual period and showing the distribution of outcomes for advanced imaging orders. AUC Reporting can also be used for auditing specific consultations. The user can specify the UCI of any consultation and the system will display a complete summary of the consultation.
The LogicNets AUC Solution provides the full range of capabilities mandated by CMS for compliance with the PAMA AUC requirement. Yet, it is about much more than fulfilling a bureaucratic process. It can work silently in the background and then be brought into the foreground on demand to provide meaningful diagnostic insights. It unifies the often-disjointed processes of ordering and furnishing imaging into a collaborative workflow. Some of its most useful features include:
Seamless integration with EHR and clinical workflow to avoid re-entry of data
Silent mode and unobtrusive interface for maintaining productivity
On-demand access to unique visual guidelines interactive interface, allowing clinical staff to rapidly validate their understanding of underlying diagnostic and treatment algorithms
Emergency override
Instant notification of inapplicable orders
AI-based “My Top Scenarios” repeated orders short-cut with 2-click attestation
Ability for ordering physicians to override recommendations with an explanation
On-demand contextual access to reference and educational information and aids
Full informatics and data integration compatibility with clinical workflow systems
Support of all common informatics code sets
Management of access to all historical consultations with Unique Consultation Identifier lookup option
Standard CMS-mandated physician and provider reports and robust advanced and graphical reporting