Turning Up the AC

ACR Appropriateness Criteria® integrated with decision-support software? See for yourself.turning up the AC

For nearly two decades, physicians and radiologists have lauded the ACR Appropriateness Criteria® (AC) program as the go-to resource for imaging decision support.

The criteria are used by payers, radiologists participating in accountable care organizations, hospitals, and private practices throughout the world to help ensure the use of appropriate imaging.

To keep this valuable resource up to date, the College announced in July the launch of a new iteration of AC — ACR Select — that could be seamlessly integrated into computerized physician order entry (CPOE) systems and electronic health record (EHR) programs.
ACR Select provides systematic, evidence-based decision support for more than 130 diagnostic topics and 614 variant conditions. This product is designed to cement the AC program as an even more indispensable national standard for imaging decision support.

“The commitment from major EHR technology providers to integrate these standards [into their solutions] is a testament to the importance of promoting appropriate medical imaging use.” — Paul H. Ellenbogen, MD, FACR

Appropriate Convenience

To accomplish this monumental task, the ACR contracted with licensing agent National Decision Support Company (NDSC) of Andover, Mass., to make ACR Select commercially available to hospitals, referring physicians, and others who seek AC guidance when ordering a procedure.

"AC Select will have a substantial impact on the health care community by bridging the gap between medical providers and the ACR Appropriateness Criteria guidelines," states ACR Board of Chancellors Chair Paul H. Ellenbogen, MD, FACR, in a July 2012 press release (available at http://bit.ly/ACPressRelease). "The commitment from major EHR technology providers to integrate these standards [into their solutions] is a testament to the importance of promoting appropriate medical imaging use."

Michael Mardini, founder and CEO of NDSC, believes that the integration of AC into CPOE and EHR systems could change the decision support process. Until now, he notes, it has been a challenge for referring physicians to use the AC because in the past they were primarily available in PDF. In order for physicians to effectively use the AC, says Mardini, "this information has to be available to physicians when they contemplate placing the order. ACR Select will provide the capability of integrating the AC into EHRs such that guidance will be available at the time of order during the normal course of the care process."

acr select

Taking the Lead

In addition to streamlining the ordering process, ACR Select places radiologists at the forefront of decision-support, giving them a more prominent role in the clinical pathway. The product will also help combat reimbursement cuts by helping imagers take responsibility for reducing unnecessary imaging. "Radiologists can add value to their roles, help reduce unnecessary imaging, and make sure it's done right," Mardini says.

Radiologists can also help establish AC and ACR Select at their hospitals and practices, asserts Mardini, by recommending the product to their colleagues. After all, many practice managers and hospital administrators would likely understand the argument that it is potentially less expensive to use the criteria than to hire an administrator to jump through the hoops that RBMs, payers, and others use to dissuade referring physicians from ordering certain imaging procedures.

To flexibly address the varying needs of organizations, ACR Select can be licensed in a variety of formats.

Improving the AC

Additionally, ACR Select will include feedback mechanisms integrated into the database so that users can provide their opinions on the AC. "A significant component of this effort is to ensure we are capturing market feedback in a meaningful and timely manner and that there is a process to continue to make the AC more complete and useful," Mardini says.

Not only will the implementation of ACR Select benefit the field of radiology, but it also has the potential to change the entire face of medicine and how medical procedures are ordered. "[In the future,] I don't see people ordering tests without decision-support and alert systems to help make sure things are being done correctly," Mardini says. "This is going to change and disrupt the entire preauthorization process."

For more information about ACR Select, visit www.acrselect.org or call 855-475-2500.

By Brett Hansen

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