Johns Hopkins has developed a workflow to integrate a CMS approved clinical decision support mechanism within Epic and CareLink to create a seamless ordering experience that complies with the new law and associated regulations. Ordering through one of the decision-tree guidelines designed by teams of Hopkins faculty ensures that all of your orders will be adherent to our AUCs. Alternatively, if you place a direct order for advanced imaging at a Hopkins imaging site through Hopkins Epic or Hopkins CareLink, the AUC consultation will occur in the background for most orders, minimizing interruptions to ordering provider workflow. An actionable alert will fire only if an order contravenes one of the few, high quality Hopkins AUCs and the software engine can’t find evidence in the patient’s medical record that reflects an appropriate indication. There are no hard stops, so when an alert fires providers may opt to proceed or change an order. We have worked very hard to design a system that promotes appropriate imaging while minimizing non-actionable alerts or interruptions; other imaging sites may launch AUCs for every advanced imaging study, resulting in numerous workflow interruptions for alerts that are not actionable.

Johns Hopkins is one of 22 provider-led entities in the U.S. approved by the Centers for Medicare & Medicaid Services (CMS) to develop AUCs. Multidisciplinary teams of Hopkins providers have created a limited number of AUCs based on high quality evidence to ensure that our patients benefit from the right study, performed the right way, at the right time.

See Imaging Appropriateness Criteria for:

• Abdominal CT with & without contrast
• Acute Pelvic Pain in Reproductive Age Group
• Breast MRI
• Breast Screening
• Coronary CTA for Stable Chest Pain
• Headaches: Imaging Appropriateness Criteria
• Hip and Shoulder Pain
• Lower Back Pain