1. Connecting clinical workflows with Advanced Visualization
Rick Gouse

2. ©2015 General Electric Company – All rights reserved
©2015 General Electric Company – All rights reserved. The results expressed in this document may not be applicable to a particular site or installation and individual results may vary. This document and its contents are provided to you for informational purposes only and do not constitute a representation, warranty or performance guarantee. GE disclaims liability for any loss, which may arise from reliance on or use of information, contained in this document. All illustrations are provided as fictional examples only. Your product features and configuration may be different than those shown. Information contained herein is proprietary to GE. No part of this publication may be reproduced for any purpose without written permission of GE. DESCRIPTIONS OF FUTURE FUNCTIONALITY REFLECT CURRENT PRODUCT DIRECTION, ARE FOR INFORMATIONAL PURPOSES ONLY AND DO NOT CONSTITUTE A COMMITMENT TO PROVIDE SPECIFIC FUNCTIONALITY. TIMING AND AVAILABILITY REMAIN AT GE’S DISCRETION AND ARE SUBJECT TO CHANGE AND APPLICABLE REGULATORY CLEARANCE. GE, the GE Monogram, Centricity, and imagination at work are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies. General Electric Company, by and through its GE Healthcare division.

3. Where is Workflow in Enterprise Imaging?
Radiologist
Specialized
Department
Connected
Enterprise
Open
Community
Dynamic
Multi-ology information Viewer
Clinical
Archive
Infrastructure
Leverage
Investments &
Optimize Costs
Unify
Web Viewing
& Smart Apps
Visualization & Accessibility
Optimize
Workflows and Reporting
Workflow
& Collaboration
Connect
Care pathways & Information
Connectivity
& Analytics
Sharing

4. The Evolution of “RIS” Intake and Management of Relevant Data
Pre-exam Tasks
Intra-exam Procedures
Post Exam Directives
Follow-up Tracking

5. The breakdown of workflow
Workflow Application Areas
Intake and Management of Relevant data
Patient Registration
Order Placement and appropriateness
Referring Physician Notifications / worklist
Pre Exam Workflows
Order and Schedule Refinement
Patient and exam clinical data mgt.
Exam exactness and protocoling
Intra Exam Workflows
Patient arrival and pre-exam tasks
Intra-exam tasks
Exam QC and Image Mgmt
Nursing Care
Charge Capture
Post Exam Workflows
Interpretation and report creation
Report review, approval and signature
Post-exam and follow-up directives
MDT and other reviews

6. Customer Defined Workflow Controls
Workflow control framework providing:
Unlimited Exam specific tasks and task groups
Tasks supported by Rich Content and User Control
Ability to build fine-grain workflow scenarios from order to exam results distribution and post-exam follow-up
Tracking tasks execution with timing, duration and delays.
Workflow control hub embedded to Imaging Desktop for basic Tech Workflows: begin, complete, QC exam
Workflow control features available for RIS-IC user via legacy UI
Trigger
Step N
Worklist
Task
Data
Result / Status
Action
Done

7. Intake and Management of Relevant Data
Pre-exam Tasks
Intra-exam Procedures
Post Exam Directives
Follow-up Tracking
Role
Activity
Referrer
CT Enterography exam ordered on a patient with ongoing abdominal pain
Scheduler
History and indications obtained
Allergies recorded
Exam scheduled
Patient education performed
If patient is allergic to IV contrast, an MRI may be done instead (Gadolinium used as contrast in MRI may be better tolerated)

8. Intake and Management of Relevant Data
Pre-Exam Tasks
Intake and Management of Relevant Data
Pre-exam Tasks
Intra-exam Procedures
Post Exam Directives
Follow-up Tracking
Role
Activity
Billing clerk
Pre-authorization documented
Radiologist
Review of all relevant forms/labs/data
Exam protocoled
Nurse/Tech
GFR calculated and reviewed
Patient education performed
IV started
Volumen given w/instructions
A GFR greater than 60 is desired; between 60 and 40, the patient is asked to orally hydrate for a couple days post injection; and lower than 40, the patient needs to be hydrated with IV fluids before and after the exam, and be monitored by a nurse during the exam timeframe.

9. Intake and Management of Relevant Data Intra-exam Procedures
Pre-exam Tasks
Intra-exam Procedures
Post Exam Directives
Follow-up Tracking
Role
Activity
Nurse/Tech
Document contrast
Patient education performed
Start IV contrast
Tech
Perform imaging study
Monitor IV
Perform exam tracking steps
Monitor the patient’s vital signs
If any extravasation of IV contrast occurs during the exam, an “Extravasation Report” needs to be filed and proper nursing care for the patient performed.

10. Intake and Management of Relevant Data Intra-exam Procedures
Post-Exam Directives
Intake and Management of Relevant Data
Pre-exam Tasks
Intra-exam Procedures
Post Exam Directives
Follow-up Tracking
Role
Activity
Nurse/Tech
Remove IV
Monitor the patient’s vital signs
Tech
Complete exam tracking steps
Radiologist
Review imaging for completeness
Provide and document post-exam instructions
Interpret the study and Record recommended imaging or clinical follow-up
Coordinate care with other specialties, as needed (for example, if the patient is recommended to have a small bowel biopsy based on the results of imaging).

11. Intake and Management of Relevant Data Intra-exam Procedures
Follow-up Tracking
Intake and Management of Relevant Data
Pre-exam Tasks
Intra-exam Procedures
Post Exam Directives
Follow-up Tracking
Role
Activity
Care Coordinator
Document recommended imaging or clinical follow-up
Nurse/Care Coordinator
1-day post-exam patient call to check IV site/general condition
Radiologist
Review pathology if biopsy was ordered
QA Monitor
Document compliance with PQRS and Centers of Excellence measures
Monitor compliance with recommended imaging or clinical follow-up
Full documentation of all events in the care continuum allows establishment of “models of care”, supports audit reports of documented events for accrediting bodies and for P4P, and provides care-specific marketing analytics.