Diagnostic Radiology has been at the center of clinical decision support discussions for a long time, especially considering the debates over radiation exposure campaigns. Different organizations have come forward to support moves for legislation requiring the justification of ordering procedures such as magnetic resonance imaging and computed tomography.
With federal regulations, physicians could have a better idea of how and when to request more in-depth scans for patients. According to Diagnostic Imaging, a new bill was approved on March 31, 2014, by the U.S. House of Representatives that would require providers to consult with mandated appropriateness guidelines that are developed by other physicians on advanced imaging procedures.
Called the Excellence in Diagnostic Imaging Utilization Act – or H.R. 3705 – the bill is backed by the American College of Radiology, which also helped devise some of the language of the legislation. Previously, the Sustainable Growth Rate Repeal and Medicare Beneficiary Access Act of 2013 had similar criteria for the appropriate ordering of diagnostic exams. The ACR has backed the use of clinical decision systems for quite some time, including its own ACR Select.
Introduced by Reps. Erik Paulsen (R-MN) and Jim Matheson (D-UT), the bill would require the Secretary of the U.S. Department of Health and Human Services to determine appropriateness criteria based on those endorsed by national medical societies, such as the ACR.
What would its impact be?
Following its approval in the House, the bill now moves to the desks of U.S. senators for an official vote. If signed into law, the legislation could have a significant impact on digital imagingstandards in health care.
“Using CDS tools embedded with physician-developed appropriateness criteria will ultimately improve the accurate ordering of advanced diagnostic studies and ensure the appropriate studies are done for the right reason on the right patient. We think this is absolutely the poster child of where policymakers want to go across the board for all issues of care,” said Cindy Moran, assistant executive director of the ACR, quoted by Diagnostic Imaging.
Provided its passing by the Senate and signing from the President, the law would take effect in 2017.
What is ACR Select?
According to the National Decision Support Company, ACR Select is the web-based version of the appropriateness criteria developed by the ACR. The tool is a comprehensive database of national standards on clinical decisions that provides evidence-based support for the utilization ofmedical imaging. The expert panels on ACR Select include more than 300 volunteer physicians from specialty organizations who continuously update the imaging guidelines and give real-time access to the latest support systems.
Perhaps the most beneficial aspect of the tool is its ability to easily integrate with disparate systems and electronic health records software, allowing medical centers to follow ACR guidelines and ensure that patients receive the right procedure for the corresponding condition.
The ACR explained that clinical decision support tools in health systems, such as the Massachusetts General Hospital, have shown evidence of reducing duplicate scans and decreasing associated costs. With federal regulations on digital radiography, the entire industry could experience significant financial gains.
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Ronny Bachrach
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