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rScriptor

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by

John Stewart

on 15 July 2016

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Transcript of rScriptor

r
Scriptor
Software that works with your voice recognition application to convert it into a highly-capable
Radiology Reporting System
Narrative
or
Structured
reports
Checks
reports for
errors
/
omissions
Creates
customized reports
Performs data
analytics
r
Scriptor
At its core is an custom-designed realtime Natural Language Processing (
realtime NLP
) system
This NLP algorithm has been painstakingly
trained by a radiologist
on over 100,000 radiology reports
Continuous feedback
system
Quality
Reports

Reimbursement
-
Undercoding
r
Scriptor

report templates
Exam

clearly defined
Technique

written to ensure reimbursement
Findings

section
- contains anatomy required for full reimbursement
Missing information for

proper coding
Pop-up menu

appears allowing radiologist to input this information

Referring Physician Satisfaction
Standardized

reports
across entire practice
Reports
easier to read
Reports can be
customized
for a referring physician or practice
Can accommodate
special
reporting
requests
Radiologist Satisfaction
Quality reports with
less effort
Increases
productivity
Increases practice
capacity
to handle volume spikes
Eyes on images
at all times
Checks report
for errors / ICD-10 / PQRS compliance
r
Scriptor

Reimbursement
Efficiency
Analytics
Satisfaction
Control
r
Scriptor
Realtime NLP
Inserts dictated text in the right place in the
structured report
Checks reports for
errors
/
ICD-10
/
PQRS
Checks reports for
acute
/
critical
findings
Direct database connectivity for
analytics
In
creases radiologist productivity
r
Scriptor
Realtime NLP
drives
Efficiency
Analytics
Quality Reports
drive
Referring physician satisfaction
Reimbursement
"Branding"
r
Scriptor

Radiology Reporting System

Structured Reporting
Promoted by
RSNA Reporting Initiative
Report Template Library
ACR Imaging 3.0
Realtime NLP inserts dictated text into a
report template
Error checking
ICD-10
/
PQRS
validation
Narrative Reporting
Narrative
dictation in
Findings
section
Remainder
of report is

standardized
Error checking
ICD-10
/
PQRS
validation
Added validation step to ensure
report completeness
(part of "
checklist
" functionality under development)
Efficiency
All reports
rScriptor writes subjective portion of report
Structured Reports

Fills in negative findings automatically
Allows radiologist to dictate findings and impression simultaneously
By
eliminating inefficiencies
in the dictation process, radiologists can see a
24%
(narrative)
to 32%
(structured)
increase in productivity
Reimbursement
Sources of lost revenue
Undercoding
ICD-10
requirements
PQRS
requirements
Critical findings
communications
Analytics -
r
Scriptor
Normalized
set of reports by CPT code
Findings section is
standardized
Every dictated finding is
scored for acuity
Negative, Incidental, Positive, Acute, Critical
Web-interface
to analytics reports
Referral patterns
Productivity
Error elimination - Quality metric
ICD-10 compliance - Value metric
Control
Radiologists
need to
control
Quality
Data
Analytics
Utilization
Feedback
to healthcare organization needs to be
continual
and
actionable
Control
If
radiologists
continue to
lose this control
Quality
- will be dictated by policymakers (e.g. MQSA)
Data
- will most likely be of
poor quality
and in the control of healthcare organizations
Analytics
- will be performed on poor quality data by
non-radiologists
Utilization
- will be
driven by bad data
and
bad analytics

r
Scriptor
- Summary
Improves
quality, efficiency and referring physician satisfaction
Optimizes
reimbursement
Protects
against future PQRS penalties
Savings
should exceed license fee by 10x
Detailed and
accurate analytics
Maintains
radiologist control
of data, analytics, outcomes and utilization
Improves
radiologist satisfaction
Reimbursement
-
PQRS
2016 Changes
50% of reports
must satisfy PQRS measures
Penalty
applied in
2018
2% reduction
in
all Medicare payments
If
> 50% of radiologists
don't meet requirements,
additional 4%
on all
Medicare payments
Quality Reports
Standardized Reports
for entire practice
Easy to
locate information
Referring physicians
Radiologists
- for comparison
Coding
/
Billing
team
Similar appearance
- Important for
branding
Reimbursement
-
Undercoding
Research on radiology coding demonstrates radiology practices
routinely undercode
many exams
Ultrasound, CT Angiography, X-rays
Most common reasons for undercoding
Technique
is incorrect or incomplete
Several
similar exam types
Report
omissions
(required anatomy)
Reimbursement
-
Communications
Failure
to
communicate critical findings
At least 1 factor in
80% of lawsuits
Approximately
doubles award
rScriptor checks
to see if
radiologist marked
finding as
critical
If not,
warning message
Activates communication system
Reimbursement
-
ICD-10
Indication and Diagnosis codes
Increased 4.8x
to 69,823
Left/right/unspecified
Greater body part specificity
Greater diagnostic specificity
r
Scriptor
Procedure specificity
(e.g. "pain")
Realtime NLP
report validation
Reimbursement
-
ICD-10
Procedure codes
Increased 18.5x
to 71,924
Left/right
Greater body part specificity
rScriptor
Clearly

defines
body part examined
Exam
title,
technique
,
findings
section
Reports follow
ICD-10 system
Greater detail than CPT / ICD-9
Reimbursement
-
Goals
Automatically include
required
information
whenever possible
Teach radiologists
what additional detail is required for certain diagnoses
Warn radiologists
when detail is not present or additional action required
Provide a
flexible
set of
tools
to
check
any part of a
report
for required content
Stop reporting errors
before
they happen
Reimbursement
-
PQRS
Realtime NLP review
If
PQRS
information missing
rScriptor
generates a
warning message
describing what information is required
Radiologists provide
missing information
before
report is
signed
First Steps
Issues to consider
as a group
Does your group want to make
report standardization
a
priority
?
Does
reimbursement
outweigh the desire to create free-form radiology reports?
Is
analytics important
to your practice (or do you think it will be important in the future)?
The answers to these questions will determine if
r
Scriptor
or some other product is right for your practice.
Full transcript