Farmington Endoscopy CDSS and cancellation model guide

The first task looks small and is graded on reasoning: propose at least two more information or data elements for the clinical decision support system, each with its own rationale. The rationale is the assignment, so every element you add must be tied to a decision the system would then be able to support, and in an endoscopy center the decisions that matter are whether the procedure should proceed, whether the preparation will be adequate, and whether the patient will actually arrive on the day. Say what decision each element informs and what the system does with it — an alert, a flag, an order change — rather than presenting a wish list of fields the center could theoretically collect but would never actually act upon, which is the failure mode that turns decision support into another data-entry burden for the pre-procedure nurse.

Elements that earn their place include anticoagulant and antiplatelet therapy with the last dose taken, since it drives hold instructions and bleeding risk; diabetes status with the insulin or GLP-1 regimen, because fasting and bowel prep interact directly with glycemic management; prior incomplete or poor-preparation studies, which predict repeat inadequacy better than almost anything else in the chart; anesthesia risk indicators such as sleep apnea screening or ASA class; and confirmation of an escort for sedation discharge, which is the single most common day-of cancellation trigger in any sedation setting. Each of those is defensible precisely because it changes what the care team does before the patient ever arrives at the center, and each of them maps to a documented cancellation or complication pathway in the endoscopy literature rather than to a general sense that more captured information is somehow better.

The second task asks for a model, and the word should be taken literally: a named, structured approach rather than a list of suggestions. Build it cause-driven, because cancellations decompose into distinct causes needing distinct countermeasures — inadequate preparation calls for instruction redesign and confirmation of understanding, no-shows call for staged reminders and advance escort verification, medical and medication issues call for the CDSS elements you just proposed working upstream, and financial cancellations call for earlier authorization. Present inputs, intervention points along the patient timeline, and measures such as cancellation rate by cause, so the model can be evaluated rather than admired. Two pages is tight for two tasks, so keep the CDSS section compact, give the model the room it needs, and make the two halves connect explicitly — the elements you proposed should appear inside the model as the mechanism that flags the at-risk case in advance.