March 2015 | AXIS Imaging News

By Teri Yates, Accountable Radiology Advisors

There have been a variety of mechanisms employed by payors in recent years to control imaging utilization and costs, including prior authorization, radiology benefit management, and bundling payment for multiple examinations performed on the same day. In parallel with these payor-driven strategies, initiatives launched by professional medical societies also have been deployed to promote more appropriate use of diagnostic imaging. These include campaigns such as Image Gently to reduce unnecessary radiation exposure in children, or Choosing Wisely to encourage patients to question and avoid imaging procedures with no clear clinical benefit.

All imaging providers have been impacted to varying degrees by these programs, and there is more change on the horizon in the form of mandated use of clinical decision support (CDS) software. CDS is a tool to educate providers at the point-of-order about the clinical appropriateness of their proposed use of diagnostic imaging. The CDS software, which may be integrated with the electronic health record order entry system or accessed through a stand-alone web portal, analyzes details of the patient’s condition to determine if the radiology procedure ordered is indicated. This determination of appropriateness is based on the specific guidelines that are employed in the system; in circumstances where an order is not appropriate, the software also provides the ordering physician with recommendations about what alternatives are indicated given the clinical scenario.