ESR iGuide pilot tests started in Europe in 2016,
and ESR iGuide was implemented in hospitals across Europe and the Middle East throughout 2017 and 2018,
with ten sites live at the end of 2018.
The first phases of pilot projects in Croatia and Sweden were concluded in 2017,
with a second phase being initiated in 2018 in both countries.
The implementation of ESR iGuide in one healthcare organisation is typically a project with a duration between three to five months,
containing the following phases:
Phase 0: Preparatory phase and scope definition
Phase 1: Procedure mapping preparation,
system build,
testing
Phase 2: Mapping organisational procedures to ESR iGuide exams
Phase 3: Testing,
training and communication
Phase 4: Go-live and collection of feedback and usage statistics
The following provides a brief overview of some of the implementations of ESR iGuide in Europe and beyond:
ESR iGuide pilot project in Hospital Clinic Barcelona,
Spain
After an initial ACR Select pilot test at the Hospital Clinic in Barcelona,
the Clinic has fully switched to ESR iGuide,
which was integrated into a new order entry system used by General Practitioners.
Over the course of 2018,
the ESR iGuide integration with the ECAP system was upgraded,
and the Clinic introduced the latest version of the ESR's referral guidelines.
Pilot results indicated that utilising the advice provided by ESR iGuide,
referrers requested appropriate imaging studies 89 percent of the time.
ESR iGuide pilot project in Jönköping,
Sweden
After successful implementation of ESR iGuide since April 2017,
the pilot project in five clinics in Jönköping County,
Sweden,
is now providing outstanding results.
The implementation included the internal medicine department at Eksjö hospital as well as 4 GP clinics.
Following an initial,
technically limited integration,
positive results were used as the basis to develop a full integration of ESR iGuide into the referral workflow,
which is used in a second phase of the project since November 2018.
CDS analytics show that with the use of ESR iGuide,
the referrals for exams deemed inappropriate according to the ESR's guidelines has been decreased to around 1 percent.
ESR iGuide pilot project in Saudi Arabia
ESR iGuide was implemented by the National Guard Health Affairs medical centre in Riyadh for a proof of concept test,
with decision support in live clinical use since November 2018.
MIDAS study
A consortium of four hospitals in Germany secured funding for a study on the impact of referral guidelines and decision support,
with a project start of April 2019.
The consortium includes the chair of the ESR's Referral Guidelines Subcommittee,
advising the participating institutions on the study design and methodology for evaluation of results.
Results will be evaluated after a 12-month period of clinical use of ESR iGuide.
Publication of the ESR guideline methodology in Insights into Imaging
The ESR Referral Guidelines Subcommittee (RGSC) is charged with developing and maintaining the content of ESR iGuide and review and adapt the ACR Appropriateness Criteria and ACR Select content for use in Europe.
The methodology for this process was submitted as a publication to the ESR's Insights into Imaging journal in January 2019.