## Overview Once your historical data is successfully parsed, we will populate the dashboard view with a visualization of your imaging exams and the recommendations made within those reports. ## Closed-Loops Rate This shows what the practice's total closed-loop's rate is including the other recommendation status's such as * Scheduled Not Completed * Rx Received And is calculated as follows: `Adherent + Scheduled Not Completed + Rx Received / (Adherent + Overdue + Coming Due + Non Compliant + Scheduled Not Completed + Rx Received )` ![2758](https://files.readme.io/48e0a51-closed-loops.png "closed-loops.png") ## Historical Adherence As a baseline, we will populate a historical adherence graph for you that shows counts of your recommendations and where the recommendation's status was relative the due date and the month selected. The adherence rate is calculated based on the recommendation counts in each of the columns as `Adherent / (Adherent + Overdue + Coming Due + Non Compliant)` \*`Exclusion` - we show you the `Non-mature` count in the graph however it is NOT included in the adherence calculation ![2788](https://files.readme.io/c1f5562-Screen_Shot_2022-04-29_at_2.52.47_PM.png "Screen Shot 2022-04-29 at 2.52.47 PM.png") ### Filters This graph is filterable by a number of dimensions that you can combine including: * Radiologist * Recommended Modality * Recommended Anatomy * Timeframe Extracted ![2790](https://files.readme.io/c8a7cfb-Screen_Shot_2022-04-29_at_2.52.55_PM.png "Screen Shot 2022-04-29 at 2.52.55 PM.png") There is a `hover` state that will give you the inputs for that month and individual adherence rate. If you click that month if will also bring you to a bar graph representation of that month. ![2840](https://files.readme.io/11459ca-Screen_Shot_2021-11-16_at_1.54.44_PM.png "Screen Shot 2021-11-16 at 1.54.44 PM.png") ## Aggregate Charts There's a few core components of the analytics overview that help give insights into how your follow up process is performing. 1. `Recommendations Histogram` - A time series graph that shows your imaging exams and how many of those exams we tagged that have follow ups recommended at an aggregate level. 2. `Recommended Modalities` - If a report suggests a follow up with a specific modality, it will show up within this aggregate chart, by default we show the top 5 most recommended and bucket the rest into an `others` category which you can see in more detail within the Follow up List. 3. `Recommended Anatomies` - If a report contains a recommended anatomy, it will show up within this aggregate chart, by default we show the top 5 most recommended and bucket the rest into an `others` category which you can see in more detail within the Follow up List. 4. ` Initial Modalities` - This shows the modality breakdown of your reports with a capability to filter around only the modalities that create the most recommendations 5. `Reco Rate Funnel` - We tag each report with associated timelines and assign a status value detailed further below and in this view show an aggregate value of those recommendation status' ![2880](https://files.readme.io/08b8aae-Overview-Analytics.png "Overview-Analytics.png") > 📘 What do we consider a recommendation? > > At a high level, we track sentences within the radiology report that specifically recommend a follow-up imaging exam (e.g. “CT”, “MRI”, “Mammogram”). Our Natural Language Processing, tags each report and extracts key information around recommendations such as: > > 1. Is there a follow up recommended? > 2. What modality is the recommendation for? > 3. What anatomy is the recommendation for? > 4. When should the patient come in for that recommended exam? > > What counts? > > * Include cases that specifically recommend follow-up imaging > * Include cases that recommend interventional procedures (e.g. FNA, ultrasound guided) > * Multiple recommendations - we track each recommendation separately if a report includes more than one recommendation > > What don't we count? > > * Exclude cases that don’t recommend follow-up imaging (e.g. “per guidelines”, “per protocol”) > * Exclude follow-up recommendations for direct visualization, biopsies, or other specialty visits > * Exclude cases with a minimum follow-up timelines greater than 12 months ## Recommendation Timeframe For the recommendation timeframe, we assign some basic rules to what we find in the report text. Ideally, there is a complete timeframe recommendation in the report, but just in case there's not, here's our approach. | Type | Range Start (Reco Min Date) | Range End (Reco Max Date) | | :------------------------------------ | :----------------------------- | :----------------------------------- | | no\_timeframe\_identified | plus 90 days from exam date | plus 120 days from exam date | | incomplete\_timeframe\_missing\_end | extracted value | plus 30 days from `range_start` date | | incomplete\_timeframe\_missing\_start | minus 30 days from `range_end` | extracted value | | complete\_timeframe\_identified | extracted value | extracted value | ## Recommendation Status Definitions After the timeframe is extracted and other data is gleaned from the report, we then assign a `status` to each of the recommendations based on the time it is prescribed to occur.

Status	Description
`Non-mature`	The report containing a recommendation for follow up is greater than 30 days before the timeframe Recommended Min Date\ i.e Today = 03/01/2021\ RecoMinDate = 05/01/2021
`Coming Due`	Today's date is at least 30 days before the `Reco Min Date` but before the `Reco Max Date`
`Overdue`	Today's date is 1 day after the `Reco Max Date` but before 60 days after
`Expired`	Today's date is after the Reco Max Date plus 60 days
`Adherent`	The reports recommendation was completed with a subsequent imaging report that falls within the `Adherence Range` (before the recommendation status has changed to expired)

## Calculating Adherence & Closing the Loop > 📘 How do we calculate adherence you ask? > > Each recommendation we identify is converted with the time ranges as noted above with either the actual value or the imputed value. On a historical basis, we are able to determine the `Baseline Adherence` and a probability used for future monthly reporting of adherence ![686](https://files.readme.io/8de40d0-AdherenceRange.png "AdherenceRange.png") ## Recommendation Action Our mission is to enable open and effective dialogue about the clinical necessity, risk and benefit of radiology recommendations. In the triumvirate of the radiologist, referring doctor, and patient relationship, we enable the collection of 1st party feedback through messaging. The intent of those messages then effectively `**closes-the-loop**` based on that dialogue and is updated automatically (or manually) in the `Recommendation Action Status`

Status	Description
Adherent	The Patient has completed the recommended exam and the `ExamDate` completed time falls within the `range_start` and `range_end` values of the recommendation (Adherence Range)
Referrer\_Acknowledged	The Referring doctor has received a notification in their EHR and we've received an HL7 response that they have seen the recommendation and will take responsibility with the patient to follow up
Patient\_acknowledged	The patient has received a notification we've received a response that they have seen the recommendation
Not\_clinically\_necessary	The Referring doctor responds to a message communications with the intent that its not necessary for the patient to continue with this recommendation based on additional clinical context they have
Completed\_elsewhere	The Referring doctor or patient responds to communications with the intent that they have received the recommended exam but went elsewhere to get it.
Scheduled\_not\_completed	A future appointment is created for a future date and matched to the recommendation from the original report
Patient\_deceased	Feedback has been received from the referring doctor or the communication channel on file with this unfortunate news
Unsubscribed	It is law that we provide the ability for folks to not receive messages anymore, so in the event that this response is given with this intent we update accordingly
Navigator\_closed	The radiology admin / care coordinator can manually close a case with the application.
Needs\_prior\_auth	The patient is awaiting insurance authorization to schedule the exam
Needs\_prescription	The patient is waiting for an order from a referring physician to confirm the medical necessity of the exam.