Radiologist Ashima Lall, MD, MBA, FACHE, told attendees at the recent CMS Quality Conference 2018 that taking part in R-SCAN improved ordering of CT angiography to evaluate pulmonary embolism in her health system by 45 percent. She spearheaded the effort within Main Line Health, an integrated health care system in suburban Philadelphia.
“We were very excited about the significant achievement in improved ordering of exams,” says Lall. “We hope that other providers around the country take advantage of the opportunity to improve care that R-SCAN allows.”
Lall, System Chief of Performance Improvement with Radiology Associates of the Main Line, found a willing partner in emergency physician Rebecca Pasdon, MD with Main Line Emergency Medicine Associates. Lall and Pasdon focused their collaboration on the Choosing Wisely topic “Do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative D-dimer assay results” at Riddle Hospital in Media, PA.
Cases ordered for suspected pulmonary embolism were reviewed retrospectively using the ACR Appropriateness Criteria’s evidenced-based guidelines to determine the extent to which imaging exams ordered added value to patient care before and after an educational intervention. Together the team achieved a 45 percent improvement in the appropriateness rating of imaging exams ordered for suspected pulmonary embolism.
Both practices earned Improvement Activity credits for 2017 for the Merit-based Incentive Payment System (MIPS) track of the QPP. Next steps include carrying out R-SCAN at other Main Line Health facilities.
Lall emphasizes that the R-SCAN “turnkey” program was instrumental in carrying out the collaboration.
“We were pleased to share our results with CMS and the field of health care experts. It was gratifying to show how the project is helping both practices be successful in the CMS Quality Payment Program (QPP).”
The CMS Quality Conference was attended by over 2,500 thought leaders in American health care quality improvement.