Time to Revamp Out-of-Date Imaging Guidelines

Back in April, the federal government officially approved the Protecting Access to Medicare Act of 2014, which prevented an approximate 24 percent cut to Medicare payments and delayed the implementation of ICD-10 by one year. However, the legislation also included language that addressed concerns about reducing patients’ radiation exposures during medical imaging procedures.

According to MedicareAdvocacy.org, Section 218 of the bill had a quality incentive payments policy to improve radiation dosing safety in radiology. Additionally, it stipulates that the Secretary of the U.S. Department of Health and Human Services must develop a program that advocates appropriate use criteria for advanced diagnostic imaging. By 2020, the bill would require ordering physicians to be subject to prior authorization for applicable procedures.

With new requirements for dose safety, care center managers must update their imaging policies and protocols. Yet it is difficult to know where to begin and how to implement changes throughout a health system.

Jump-starting the makeover process
It is likely that most organizations have not updated imaging policies in a long time, leaving significant gaps in radiation safety procedures, AuntMinnie.com explained. Requirements for digital imaging policies have gone through many changes over the last few years, as physicians look for better ways to improve quality of care and reduce medical costs. In some states, such as California and Texas, radiology facilities must frequently update their criteria to meet regulatory standards.

Unless physicians update their policies every year, there is a good chance that they may already be outdated. While the “as low as reasonably achievable” (ALARA) principle was an industry standard, it failed to provide any legitimate radiation dose thresholds for radiologists.

In that time, the American College of Radiology and American Association of Physicists in Medicine have developed clearly defined imaging guidelines for recording dosages of equipment like X-ray and MRI systems. The PAMA of 2014 also included provisions that stated CT equipment must meet National Electrical Manufacturers Association standards to regulate dose management.

Developing new imaging policies
First and foremost, radiologists need to ensure that their clinical staff has undergone extensive education and training about dose safety. Each imaging procedure can expose patients, doctors and their nurses to radiation that can be harmful over time. Because of this, the facility should have access to up-to-date training materials that cover protocols of use of the organization’s specific equipment models. However, patients should also be able to review information that sparks discussions with physicians on the appropriateness of particular procedures.

Additionally, providers should be trained on justification protocols to assess the need for exams and promote the appropriate ordering of a particular scan. Health care centers should consider adopting automated decision support systems to ease physicians’ decision making processes. By gleaning useful clinical data from electronic health records, doctors can be aided in choosing appropriate exams from patients’ imaging histories.

Finally, health system administrators should continue to conduct research in diagnostic radiology, focusing on optimizing doses and reducing radiation exposure. This can lead to better evaluation of imaging risks and the benefits associated with radiological procedures. It would help develop a foundation for image quality and dose standards that could be applied both nationally and internationally.

The future of medical imaging will rest on physicians’ abilities to establish more stringent standards on ordering and conducting procedures. Mining EHRs and developing educational materials will serve as viable starting points for providers to lay the groundwork for radiation dose reduction and improved dosage management, as new federal guidelines will be sure to affect how scans are managed in the coming years.

Contact Viztek for more information.

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Ronny Bachrach

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Responsible for all marketing activities including, press, advertising, trade show coordination, website management, dealer and customer communications.