As medical imaging has advanced, a variety of electronic systems and their various technology-based components, such as image archiving systems, ultrasound machines, ultrasound reporting systems and billing systems, have evolved within ultrasound network architectures.
Each of these components communicate through a variety of interfaces, typically created by different vendor companies with limited collaboration, who focus on their individual components rather than seamless network connectivity.
“Because this customization requires institutional willingness and resources, most ultrasound networks do not seamlessly provide the clinical information necessary to improve clinical care efficiency and quality.” (SMFM)
To help facilitate better collaboration, clinicians, maternal-fetal medicine sub-specialists and network vendors, including AS Software, were brought together by the Society for Maternal-Fetal Medicine Clinical Informatics Committee to establish best practices and a better understanding of obstetrical ultrasound network architectures, now published by the American Journal of Obstetrics and Gynecology in a special statement.
Here is a summary of the best practices collaboratively provided for seamless prenatal ultrasound network connectivity:
1. Use a generalized approach to order design for more clinical flexibility
There are unique challenges to order design for prenatal ultrasounds due to the frequent need for mid-study adjustments in obstetrics.
The two most common approaches are to use multiple individual procedure-based orders, or to use a few generalized orders with embedded procedural options.
While each approach to order design has its limitations and may depend on unique workflows, the ideal approach is typically a generalized one. In this approach, a handful of high-level orders with procedural specificity selected within the body of each order are used. A conditional request can also be embedded based on the study results, and even extend to consultative services.
This will give greater clinical flexibility, so clinicians can adjust as needed without requiring new orders.
2. Establish a straightforward data standard to improve communication
Although there have been standards for formats of communication, like HL7 and DICOM, the content and clinical format of obstetrical data hasn’t had a standard for how it’s transmitted across systems.
Depending on the individual vendors and design of each component, there are many variations of how data transfer and format is customized through interfaces — leading to varying capacities and complicated translations of each data point that make it difficult for practitioners to effectively leverage data.
By standardizing ultrasound data transfer and improving consistency, clinicians will have increased analytical capabilities and access to discrete obstetrical data, and communication will be improved between vendors. This straightforward integration is also less costly for IT professionals.
3. Optimize billing with search functionality and integrations
ICD-10-CM and CPT are the standards for coding in ultrasound workflows, but clinics vary on how they send this information and some use paper order sets.
All requested procedures, associated diagnoses, and indications are best sent via HL7 order entry message to an ultrasound reporting system (URS). The URS should have search functionality for CPT and ICD-10-CM codes, and automatically populate necessary sections of study reports.
All billing and coding systems should also seamlessly integrate with health information systems; and study procedure and diagnosis codes should automatically populate for final review.
As imaging technology continues to advance, so will the technology-based components supporting it. These best practices will help both providers and vendors ensure their network and its interfaces are structured effectively for better communication and more standardized data transfers, relieving burdens placed on healthcare systems.
To read more about best practices for ultrasound network connectivity, read the entire special statement in the American Journal of Obstetrics and Gynecology or download a PDF on the Society of Maternal-Fetal Medicine site.
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