ACR Bulletin

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The Year in Quality and Safety

The ACR Q&S team reviews the biggest highlights for 2018.
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We’re on the cusp of the AI explosion in imaging, and the DSI’s use cases are at the forefront.

—Judy Burleson, MHSA
December 14, 2018

PHOTO CAPTION: Anjali Jha, a high school student in Washington, DC, joined her mentor Ross W. Filice, MD, an associate professor and chief of imaging informatics at MedStar Georgetown University Hospital, to discuss the future of radiology at the 2018 ACR Quality and Safety Conference in Boston.

From accrediting digital beast tomosynthesis (DBT) to exploring AI at the ACR Annual Conference on Quality and Safety (Q&S), it’s been a big year for the College’s Q&S team.

Accrediting DBT

2018 saw a notable addition to the ACR’s accreditation program. On April 9, the FDA transitioned the accreditation of DBT systems to the ACR. These units were previously approved through the FDA certificate extension program. According to Krista Bush, senior director of accreditation for the ACR, “The ACR started accrediting DBT units on April 9, and since then we have had 1,476 units that have applied for mammography accreditation with their DBT units (at the time of this article’s printing). It is important that these units are accredited because DBT is an improvement over full-field digital mammography.”

Achieving Success With R-SCAN

Since R-SCAN® launched in 2015, much progress has been made in optimizing imaging care. After providing access to clinical decision support (CDS) and other tools to decrease unnecessary testing, R-SCAN participants evaluated their cumulative impact to find excellent results. Here are a few highlights:

  • 42 practices show that ordering of appropriate imaging studies improved by over 10 percent
  • More than 12,000 cases have been reviewed retrospectively via R-SCAN
  • Most projects involved imaging for suspected pulmonary embolism, low back pain, and inconsequential adnexal cysts
  • The program introduced the CDS R-SCAN Registry, now in pilot phase, which will become one of seven registries under the ACR National Radiology Data Registry.

“As R-SCAN enters its fourth year, collaborating radiologists and referring clinicians continue to demonstrate R-SCAN is a valuable tool for transitioning to value-based, patient-centered imaging care,” says Judy Burleson, MHSA, ACR senior director of quality management programs.

Focusing on AI

The ACR Annual Conference on Quality and Safety convened in October in Boston, with a new focus: AI. Attendees had the opportunity to learn more about the future of AI and its impact on radiology from the ACR Data Science Institute™.

“Quality improvement is a data-driven field,” explains Burleson. “Radiology thrives with technology advances. AI tools and algorithms integrated into imaging technology deliver valuable guidance at the point of care, allowing insight into improvement opportunities. We’re on the cusp of the AI explosion in imaging, and the DSI’s use cases are at the forefront.”

Jacqueline A. Bello, MD, FACR, chair of the ACR Commission on Quality and Safety, agrees. “We continue to be a leader in the quality space and will continue to keep ACR members updated on how to provide patients with the best and safest care possible,” says Bello, “ACR’s Annual Conference on Quality and Safety was our next step in that very direction.”

Keeping Up With PAMA

Another change from CMS has allowed the ACR’s focus on CDS to continue its impact in the healthcare field. Beginning on Jan. 1, 2020, PAMA will go into effect, requiring providers to consult Appropriate Use Criteria before ordering diagnostic imaging (including CT, MR, nuclear medicine exams, and PET scans for Medicare patients). The mandate includes a phased rollout from CMS. Starting in July 2018, early adopters entered a voluntary reporting period. And in January 2020, a one-year testing period with no penalties will commence.

Fortunately, the College already provides tools for CDS, such as the ACR Appropriateness Criteria® (AC). The AC fulfill the new CMS mandate for consulting CDS prior to diagnostic imaging in Medicare patients. Although several CDS systems exist, the ACR and the National Decision Support Company have developed CareSelect Imaging™, which uses the AC and other guidelines to advise providers ordering imaging for patients.

Author Alyssa Martino  Freelance Writer, ACR Press