Published on the March 14, 2013, DiagnosticImaging.com website
By Whitney L.J. Howell
The number of radiology practices and departments looking to benchmark themselves against their peers through data registries is growing. But many still need guidance on what these databases are and how they can correctly participate.
For years, your practice or department has likely followed its own protocol for diagnostic scans, using what you felt were best practices for radiation doses, for example. According to industry experts, data registries are pathways to double-check yourself and ensure what you’re doing provides the best care to your patients.
“These registries are effective in the promotion of quality improvement changes and changes in high-quality health,” said Cynthia Moran, assistant executive director of government relations, economics, and health policy at the American College of Radiology (ACR). “The use of registries is so that people can see where they are in the performance metric.”
Although the ACR Dose Index Registry has received the most attention recently, seven additional registries exist — CT colonography, general radiology improvement, IV contrast extravasation, mammography, oncologic PET, night coverage, and quality improvement for CT scans in children. Together, these registries comprise the ACR National Radiology Data Registry (NRDR).
By providing data to a registry, you’re contributing to the body of information that will be used to craft future best practices guidelines. According to Moran, these registries also make it easy for you to compare yourself to your peers.
“If you provide data to a group or registry, you periodically get a report to see where you stand respective to your other colleagues,” she said. “If your numbers are far off from the performance of others, you can create a process to see what’s wrong and how you can do better for your patients.”
While data registries are most often lauded for improving the quality of care available to patients, they do make a more direct impact on radiology practices, said Judy Burleson, ACR’s director of quality and safety metrics.
“When quality improvement and quality reporting programs are used in combination with reimbursement mechanics, it enables payers — private or Medicare — to pay for services for their beneficiaries based on quality rather than fee-for service,” she said. “When you integrate a quality program within payment structures, you’re inserting and element of value there.”
Ensuring Compliance
To participate in any registry within the NRDR, your practice must complete a participation agreement. Not only does this document outline the specific registry or registries in which you want to enroll — it isn’t required that you participate in all registries — but it also mandates that you have the proper privacy protocols in place to protect the patient data you collect and submit.
There are also other rules you must follow, Burleson said.
“To be in compliance with a clinical data registry like the ACR registries or specialty society registries, practices just need to submit specific data elements in the format that’s required,” she said. “This could be problematic for some sites that must figure out the best way to get this data and from where to find it.”
To read the remainder of the story at its original location: http://www.diagnosticimaging.com/articles/radiology-data-registries-know-how-comply-0
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March 18, 2013
Posted by wjpalmer |
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Published on the June 14, 2012, DiagnosticImaging.com website
By Whitney L.J. Howell
Changes to Medicare reimbursement and other financial incentives designed to control the use of diagnostic imaging services aren’t working as expected, even in clinical settings without a fee-for-service payment model, according to a study published earlier this week in the Journal of the American Medical Association. However, not all industry leaders agree that imaging utilization is on the rise.
A retrospective study of up to 2 million electronic health records from 1996 to 2010 from six health systems with health maintenance organizations (HMOs) revealed the number of diagnostic imaging studies performed increased between nearly 8 percent to 57 percent during that time period.
The findings, compiled by researchers at the University of California-San Francisco (UCSF), showed the number of ultrasounds doubled, CTs tripled, and MRIs quadrupled during those 15 years. These results indicate that financial disincentives, such as lowered reimbursement or added cost to the patient, aren’t enough to eliminate unnecessary testing, as once was the hope, researchers said.
“Some people are just unrealistically enamored with diagnostic tests. There’s a perception that there’s no harm to these tests, so we can do them and think about the results later,” Rebecca Smith-Bindman, MD, UCSF radiology and biomedical imaging professor and lead study author, said in an interview. “The pictures are extraordinary, and some patients receive enormous benefits from having these tests. But others receive no help at all — they face high radiation doses, false positives, and more unnecessary downstream testing.”
Fear of facing malpractice suits and of missing a malignancy also pushes providers to order diagnostic studies for which there is no true medical indication, she said. If these problems were resolved, she said, radiologists and referring physicians could likely avoid 30 percent to 50 percent of diagnostic studies.
Even an industry-wide shift to an accountable care organization (ACO) or bundled payment model is unlikely to be enough to drive down imaging utilization, she said. Instead, medical imaging should invest in comparative effectiveness studies to better understand when imaging is appropriate. Industry leaders can, then, use that information to create clinical guidelines.
However, several groups, including the American College of Radiology (ACR), the Medical Imaging and Technology Alliance (MITA), and the Access to Medical Imaging Coalition (AMIC) said the study’s findings actually supported existing evidence that imaging use is decreasing.
To read the remainder of the article at its original location: http://www.diagnosticimaging.com/low-dose/content/article/113619/2083399
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June 18, 2012
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