November 2018

Translating What’s Relevant to Radiologists

 

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The ACR DSI is putting radiology’s priorities into a language AI developers understand.

When algorithms are asked to go beyond identifying images of cats and dogs and solve more complex problems, the data scientists developing the algorithms must first ask three questions: What problems will be valuable to solve? Will AI be a potential way to solve them? And is there enough data available for supervised learning?

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Leading With Heart

 

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ACR RFS Secretary Nathan M. Coleman, MD, RFS Chair Daniel Ortiz, MD, and RFS Education Liaison Patricia Balthazar, MD, left the 2018 RLI Summit with a deeper understanding of several of the biggest challenges facing healthcare and radiology today.

 

The possession of emotional competency can make a great leader — and a successful radiology practice.

Arnel Pineda was a bar and club singer working in Manila in 2007 when he was approached by Neal Schon, the guitarist from Journey. Schon had seen Pineda’s videos on YouTube and was impressed by the singer’s voice, humility, and stage presence. Almost overnight, the once homeless young man from the Philippines transformed into Journey’s new frontman, catapulted to stardom, and amassed a fortune with a net worth estimated in the neighborhood of $15 million.

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The Value of Storytelling

 

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Imaging 3.0® case studies show patient-centered care in action.

If you’re an avid reader like me, you probably have a pile of digital or hardcopy books on your nightstand. While keeping up with my reading can be a challenge, an engaging book can still capture and hold my attention late into the night.

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Getting Back to Basics

 

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Applying the AUC in a CDS program is necessary and worthwhile.

When PAMA passed at the end of 2014, it mandated a simple idea — at the point of ordering, referring providers must make sure the study is appropriate. Since then, translating this simple idea into reality has become far more complex than necessary. Hundreds of pages of regulatory language, and a surprisingly high degree of resistance from the rest of the medical community, have contributed to that complexity. The result has been a delayed implementation schedule, overly complicated reporting requirements, and a disappointing opposition letter from non-radiology stakeholders.

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Clinical Decision Support

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Starting Jan. 1, 2020, PAMA will require referring providers to consult AUC prior to ordering advanced diagnostic imaging services (including CT, MR, nuclear medicine exams, and PET scans) for Medicare patients. To do this, physicians must use clinical decision support (CDS), which guides ordering physicians to the most appropriate imaging according to the AUC. CDS exists either as a stand-alone unit or through software embedded into the institution’s EHR. Although several CDS systems exist, the ACR and the National Decision Support Company have developed CareSelect® Imaging, which uses the AC and other guidelines to advise providers ordering imaging for patients.

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Taking the Lead

 

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Clinical decision support is here, and radiologists need be at the forefront.

Radiologists have long provided guidance on the correct exam at the right time for the right patient. This advice was formalized with the 1993 introduction of the ACR Appropriateness Criteria® (AC), expert-created documents that detail the best imaging for a given clinical scenario. But even with this information available, not all physicians were on board.
 
That’s about to change. Starting Jan. 1, 2020, PAMA will require referring providers to consult AUC prior to ordering advanced diagnostic imaging services (including CT, MR, nuclear medicine exams, and PET scans) for Medicare patients. To do this, physicians must use clinical decision support (CDS), which guides ordering physicians to the most appropriate imaging according to the AUC. CDS exists either as a stand-alone unit or through software embedded into the institution’s EHR. Although several CDS systems exist, the ACR and the National Decision Support Company have developed CareSelect® Imaging, which uses the AC and other guidelines to advise providers ordering imaging for patients.

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Critical Support

 

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Teaming up with referring providers can preserve reimbursement and boost quality of care.

To ensure success under PAMA, radiologists need to take the lead in educating physicians and other referring providers on the importance of adopting an approved CDS in their workflow.

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Homing in on Quality

 

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Radiologists in rural western North Carolina are strengthening their relationships with local physicians and reducing inappropriate imaging via R-SCAN®.

For radiologists at Asheville Radiology Associates, paving a new route means success in educating their referring clinicians about appropriate image ordering. However, the group faces a unique challenge in doing so: Their referring providers are distributed across a wide geographical area in rural western North Carolina.

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CDS Deadline Moves Forward Under CMS

 

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The PAMA requirement has been reconfirmed for referring providers to consult AUC for advanced diagnostic imaging services starting Jan. 1, 2020.

Following the implementation dates and guidelines for Appropriate Use Criteria (AUC) is both important and confusing. Here are the most current mandates to maintain your reimbursement status.

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Putting the Patient First

 

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CDS implementation supports patient- and family- centered care.

Clinical decision support (CDS) places radiologists at the center of value-based care and connects them with ordering physicians — but there are just as many benefits to patients. The implementation of CDS has been found to decrease inappropriate imaging, help patients understand why the procedure they’re undergoing is the most appropriate, and reduce the time it takes for patients to undergo a procedure. Research has shown that appropriate imaging also leads to costs savings, less patient anxiety, and reduced radiation exposure.

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Circling the Wagons for CDS

Circle WagonOne health system changed CDS from a top-down mandate to a team-based, patient-centered goal.

When Cambridge Health Alliance (CHA) set out to introduce clinical decision support (CDS), leaders carefully planned the logistics for its implementation. However, they also started early, getting buy-in from referring clinicians and radiologists — the ones who would actually be using the tools. Two CHA physicians (one radiologist and one family medicine physician) explain how it all came together and how CDS benefits both patients and clinicians.

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Final Read

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Michael A. Chorney

Q: Why did you decide to become an interventional radiologist?

As a resident, I’ve found that the rotation that offers me frequent moments to turn off the dictaphone and converse with patients is IR. The daily workflow on the IR service provides us with the opportunity to share time and stories with our patients.

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