News from the ACR and Beyond
New Guidelines for Women With Genetically Higher Risk of Breast Cancer
Women with “genetics-based increased risk” should have an assessment at age 30 to determine whether mamography screening earlier than age 40 is necessary, according to findings published in the JACR®. The ACR and the Society of Breast Imaging have issued new guidelines for women with increased risk of breast cancer. Because early detection decreases breast cancer mortality, women at higher risk would benefit from additional or more intensive screening, study authors note. “All women, especially black women and those of Ashkenazi Jewish descent, should be evaluated for breast cancer risk no later than age 30,” researchers noted.
Read more at acr.org/ACR_SBI.
Radiologists Have the Most Medicare Patient Encounters
Radiologists, on average, serve more Medicare fee-for-service beneficiaries than any other physician specialty group, according to findings recently published in the JACR®. The Harvey L. Neiman Health Policy Institute® researchers found that diagnostic radiologists served the highest number of Medicare fee-for-service beneficiaries; and among subspecialist radiologists, the number of unique beneficiaries served was highest for breast imagers and lowest for nuclear medicine physicians and vascular and IRs. Based on the large number of unique Medicare beneficiaries served, the findings emphasize radiologists’ important role in patient care and could help identify future patient engagement opportunities. “[The] large number of served beneficiaries sets up radiologists to have an increasingly prominent impact in orchestrating patient care within their health systems, should they choose to take on that role,” the study states.
Read more at bit.ly/JACR_Unique.
Your Diversity Snapshot
Take some time to complete the diversity and practice information on your My ACR profile, on the My ACR tab on acr.org. This confidential information will assist us in developing the appropriate programs and services for our members.
Don’t Miss Goldberg-Reeder Travel Grant Deadline
The ACR Foundation provides up to four travel grants for qualified radiology and radiation oncology residents and fellows seeking to spend at least one month assisting in a developing country. The grant were created to further encourage international volunteer service among members-in-training. Applications and accompanying materials are due June 30.
For more information, visit acr.org/ Goldberg-Reeder.
“Producing reports purely based on text [doesn’t] help patients understand why imaging is important to the quality of their care.” — Tessa S. Cook, MD, assistant professor of radiology at the Perelman School of Medicine at the University of Pennsylvania, at bit.ly/Report_Images.
Missed Appointments Tied to Wait Days and Socioeconomic Status
Increased wait days (WDs) for advanced imaging significantly increases the likelihood of a patient missing his or her appointment, according to new research published in the JACR®. And this correlation is “most pronounced among underrepresented minorities and patients with lower socioeconomic status,” the study finds. The study focused on missed outpatient MRI appointments across different demographic and socioeconomic factors. “Efforts to reduce WDs may improve equity in access to and utilization of advanced diagnostic imaging for all patients,” study authors noted.
Read more at bit.ly/Wait_Days.
Executive-Level Symposium Draws Private and Academic Practice Leaders
The RLI Leadership Challenges Symposium offers a focused program to help executive-level radiology leaders navigate modern business challenges and recalibrate practice operations to align with new healthcare models.
The comprehensive program, developed by Lawrence R. Muroff, MD, FACR, and industry experts, offers tactical guidance on the best ways to improve practice or department efficiency, adapt to new payment models, provide greater value, negotiate more effectively, and better understand the financial implications of leadership decisions. Meeting participants will also explore practical case studies illustrating the most effective strategies being used by practices nationwide.
The meeting takes place July 20–22, 2018, in Arlington, Va. To register, visit radiologyleaders.org/practical-solutions.
Cognitive Bias May Play Role in Imaging Exam Interpretation
Radiologists using heuristic problem-solving methods during image interpretation may allow cognitive bias and diagnostic errors to creep into their decision-making, according to a study published in the American Journal of Roentgenology. “Radiologists rely on heuristic principles to reduce complex tasks of assessing probabilities and predicting values into simpler judgmental operations,” study authors noted. While such principles are generally useful when interpreting images, there are several types of cognitive bias that contribute to significant diagnostic errors that remain an obstacle to improving quality in the specialty.
Read more at bit.ly/Imaging_Bias.
Improving Follow-Up of Abdominal Imaging Findings Through Verbal Communication
Radiologists who talk to their patients can “increase the likelihood that patients receive outpatient imaging follow-up for findings indeterminate for malignancy,” according to a study published in the JACR®. Researchers looked at the association between radiologist-initiated verbal communication for abdominal imaging findings and outpatient follow-up imaging compared to communication from clinicians in other specialties.
Read more at bit.ly/Followup_Talk.
Equip Your Practice for Effective Lung Cancer Screening
Prevention and early detection of lung cancer is critical as there will be an estimated 1,735,350 new cancer cases diagnosed and 609,640 cancer deaths in the United States this year, and treatment costs continue to rise1. The ACR Lung Cancer Screening Education course offers expertly-guided, interactive training to help practices implement a cost-effective screening program that’s quality compliant — along with 15 CME and equivalent SA-CME. Participants learn a patient-centered approach to shared decision-making, how to implement screening guidelines into clinical practice, the importance of being a multidisciplinary team collaborator, and how to distinguish their screening practices to providers, payers, and patients.
Access the lung cancer screening module at acr.org/lcseducation.
- American Cancer Society. Cancer Facts & Figures 2018. Available at bit.ly/Cancer_Facts. Published Jan. 4, 2018. Accessed April 30 26, 2018.
JACR Launches Data Science Column
The JACR® has introduced a new column by Associate Editor Keith J. Dreyer, DO, PhD, FACR, and ACR Data Science Institute™ Chief Medical Officer Bibb Allen Jr., MD, FACR. “Data Science and Radiological Practice” explores the clinical aspects of AI and how these important tools will be integrated into radiology. Read the first column at bit.ly/ JACR_DataScience.
With its increased focus on data science, the JACR aims to be radiology’s resource as data science transforms the medical landscape. Authors are encouraged to submit articles and substantive opinion pieces to JACR for publication under this new journal pillar.
Go to jacr.org for submission information.
Clinical Comfort From IRs
In a thriving clinical practice, IRs at the University of Virginia (UVA) regularly consult with both patients and referring providers. The approach has established the IRs as critical members of the healthcare team who have ongoing communication of their value to administrators. The IRs allocate time for outpatient referrals, clinic visits, hospital rounds, and referring physician consults to optimize patient care. UVA updates its curriculum regularly to ensure the next generation of IRs understands how to provide periprocedural and longitudinal patient care.
Read the case study at acr.org/clinicalcomfort.
ACR Efforts Impact Healthcare Worldwide
Following the 2017 RSNA Annual Meeting and the European Congress of Radiology earlier this year, it’s clear that the impact of ACR-developed programs and tools is internationally recognized, says ACR CEO William T. Thorwarth, Jr., MD, FACR. A few notable efforts, developed and implemented either solely by the ACR or in collaboration with other societies, include the ACR Appropriateness Criteria®, Digital Imaging and Communication in Medicine Standard, and the ACR Education Center, which remains a unique immersion “simulator” experience for international as well as domestic radiologists. “These are just a few examples of the influence of the ACR as we lead improvements in the ever-evolving world of radiology, both here at home and around the globe,” Thorwarth says.
Here's What You Missed
The Bulletin website is home to a wealth of content not featured in print. You’ll find blog posts, extra articles, and other updated multimedia content at acrbulletin.org.
Diversity and Inclusion in IR
How can you leverage diversity and inclusion to better serve the patient population? One potential avenue is to better understand patients’ needs. Read more at bit.ly/Diversity_IR.
Making a National Impact
ACR RFS Vice Chair Daniel Ortiz, MD, shares how his start at a modest medical program in coastal Virginia led to a meaningful journey in radiology at bit.ly/National_Impact.
Can You Be Too Close to Your Patients?
Under what circumstances, if any, would it be acceptable for a doctor to comfort a patient with a hug? Read what one consultant to medical professionals thinks about personal contact at bit.ly/Too_Personal.
“Although value manifests itself differently in different specialties, digital technology provides an important mechanism for advancing patient-centered [care in] radiology.” — Geraldine J. Liao, MD, and Christoph I. Lee, MD, department of radiology at the University of Washington School of Medicine in Seattle at bit.ly/Portal_Value.
ACR Appropriateness Criteria Celebrates 25th Anniversary, Releases New Topics
The latest edition of the ACR Appropriateness Criteria® (AC) is now available — with 178 diagnostic imaging and IR topics with 912 clinical variants covering more than 1,110 clinical scenarios. Referring clinicians can use the AC to fulfill Protecting Access to Medicare Act requirements of consulting Appropriate Use Criteria prior to ordering advanced diagnostic imaging for Medicare patients. First introduced in 1993, these evidence-based AC guidelines help ensure that patients get the right imaging for their conditions and avoid unnecessary care, says Frank J. Rybicki, MD, PhD, FACR, chair of the ACR Committee on AC. “In addition, under the guidance of the leadership of the JACR®, we have formed a subcommittee on patient engagement to directly respond to patient concerns and questions by preparing patient-friendly summaries of AC topics.”
Find out more at acr.org/AC.
“The name of the game is to create value in the delivery of radiology services: increased diagnostic certainty, decreased time on task for radiologists, faster availability of results, and reduced costs of care with better outcomes for patients.” — James H. Thrall, MD, chair emeritus, department of radiology at Massachusetts General Hospital, at bit.ly/ML_Radiology.
Early Adopters of CDS Deliver More Appropriate Imaging, Help MDs Prepare for PAMA
Early adopters of clinical decision support (CDS) at the Einstein Healthcare Network in Philadelphia have partnered with the ED and other departments to deliver more appropriate imaging and to assist ordering physicians preparing for reimbursement changes under the Protecting Access to Medicare Act (PAMA). Einstein’s radiology team has implemented a CDS algorithm to help ED physicians determine whether or not to order head CTs for pediatric patients. “Since we integrated guidelines from the Pediatric Emergency Care Applied Research Network into our EMR, adherence in the ED has increased from approximately 35 percent to 80 percent,” explains Ryan K. Lee, MD, MBA, section chief of neuroradiology at Einstein. PAMA requires providers to consult CDS for advanced image ordering.
Read more at acr.org/Ahead_Curve.