ESR iGuide implementation
As the need for CDS adoption and the benefits of implementation gain recognition, the ESR would like to provide some information on the implementation process of ESR iGuide and a few examples of ongoing projects.
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 in 2020:
In Jönköping region in Sweden, among the earliest adopters of ESR iGuide, the implementation team completed an upgrade to the latest ESR iGuide content version in close cooperation with radiological experts. Jönköping has incorporated a number of localised rules that are integrated into the standard ESR iGuide content set, ensuring that CDS ruled are tailored to local requirements and in accordance with best practices.
In Croatia, another early adopter, the ESR has worked with its partner IN2, a provider of hospital information systems, on a second, expanded phase of ESR iGuide implementations supervised by the Croatian Ministry of Health. In autumn 2020, ESR iGuide went live in clinical use in hospitals in Zagreb (Dubrava), Osijek, Bjelovar, Slavonski Brod and Rijeka. Monthly appropriateness reports are generated by the ESR to monitor results and identify potential for optimising the utilisation of radiological exams in cooperations with IN2 and the participating hospitals.
The Consorci Hospitalari Vic in Spain has begun using ESR iGuide in ‘silent mode’. This enables structured referrals without displaying appropriateness feedback to referrers, and is used to establish a baseline of the appropriateness of imaging referrals. The implementation experience at CH Vic was presented in detail at the ESR Annual Leadership Meeting, and is available on demand on the ESR Connect platform.
In the upcoming months, the ESR looks forward to working with Mevidenc, a Spanish company working to improve healthcare delivery by providing evidence-based assessments of medical decision-making and healthcare technologies in order to optimise patient safety, health outcomes, and resource utilisation. This mission is perfectly in line with the purpose of ESR iGuide, which will provide significant added value to Mevidenc’s services especially to medical insurers to drive good practice and improve cost-effectiveness.
The core of ESR iGuide is its content – referral guidelines for appropriate imaging. Completed in early 2021, the 2021 version of ESR guidelines, developed on the basis of the American College of Radiology Appropriateness Criteria, the ESR offers evidence-based and expert guidance on over 2,300 different clinical indications covering all areas of diagnostic imaging. A dedicated poster in the EuroSafe Imaging Exhibition at ECR 2021 provides more details on the latest ESR iGuide content version.