by
David Dennis, Contributing Reporter | November 28, 2016
From the November 2016 issue of HealthCare Business News magazine
Appropriateness criteria: The right test at the right time
While all perceive the potential significance of these pressures, these experts agree with Mehta’s assertion that they should not push things in any single direction. And in every case, they make reference to the importance of the ACR appropriateness criteria guidelines as the way to achieve the appropriate balance of modality use. “The place to go to for specific uses is the ACR referral guidelines. These show how conditions are being channeled to the different modalities,” says Launders.
“Standardizing care pathways, using the same tests for indications, not letting people just choose X-ray, CT, MR, whatever, is the way to go,” adds Tomlinson. In Silva’s view, there are a number of benefits to this developing system: “You want patients to get the best study possible to diagnose their condition. In addition to getting the right exam for that case, we have the benefit of physicians learning what the best exam is for future purposes. They can go to links to look at literature to see how those determinations were made, making them better doctors.
Physicians appreciate this level of support. They want to do the right thing. Some might say doctors should do what they want to do. They could override the recommendation and go with something with a lower score. But they can also consult with the radiologists as to whether the appropriateness score is correct in that particular case. This can open up the basis for cooperation aimed at making the best decision. This can result in a broader collaborative process. “I think that Medicare and the health care system want the best for their beneficiaries, but they want to do it responsibly,” Silva continues.
“This is why I think clinical decision support is a nice way to implement that by bringing all the parties together. It’s good for patients because they get the right exam at the right time. It’s good for the physicians and radiologists because they can be confident that they are ordering and doing the right exam, too. The importance of appropriate use criteria is growing. There is some pushback from Medicare and some specific physician groups that want to delay it, or do it in a less than comprehensive manner. But it is the best combination we can put together for now. Putting together information to insure appropriate ordering is the goal. Patients are all-important and we want to use the best technologies to give them the most appropriate care.”
Flexibility is the key: No single modality, but the right blend
