At a Transforming Clinical Practice Initiative (TCPI) event on Aug. 6 in Baltimore, MD, Gregory Nicola, MD, FACR, presented the Radiology Support, Communication and Alignment Network (R-SCAN)’s role in improving care coordination and reducing unnecessary testing and related health care costs.
TCPI is a four-year initiative created by the Centers for Medicare & Medicaid Services (CMS) aimed at supporting more than 140,000 clinician practices in delivering value-based care. The Support and Alignment Network (SAN) Summit brought together over 30 professional medical associations to share lessons learned from the work of the 10 SANs funded under TCPI and generate ideas and commitments toward preparing their clinician memberships for participation in value-based care payment arrangements.
R-SCAN — the American College of Radiology’s (ACR) SAN — brings radiologists and referring clinicians together to improve imaging appropriateness based on a selection of Choosing Wisely topics. R-SCAN delivers immediate access to web-based tools and clinical decision support technology that helps optimize imaging care, reduce unnecessary imaging exams and lower the cost of care.
In his presentation, Nicola noted that R-SCAN implementation has resulted in a 22 percent average improvement in the ordering of imaging exams across 80 projects in diverse care settings. More than 16,000 imaging cases were reviewed for adherence to evidence-based guidelines, engaging more than 4,000 participating radiologists and 10,000 clinician providers.
Imaging areas for improvement were based on Choosing Wisely recommendations from a variety of medical societies, such as imaging for low back pain, uncomplicated headache and minor head trauma.
In addition to the clinical and economic benefits, Nicola relayed from his personal R-SCAN participation experience that the program resulted in improved communication and strengthened relationships among colleagues in other departments.
R-SCAN will continue as a quality improvement activity of the CDS R-SCAN Registry — one of seven ACR registries — and will use CDS data to help demonstrate improvements in imaging utilization.
As health care systems begin implementing CDS technology as part of the Protecting Access to Medicare Act (PAMA) mandate, the CDS R-SCAN Registry will soon be able to provide national benchmarking data, automate reviews of ordering patterns and support the development of quality measures for value-based imaging.