Stewards of High-Value Imaging

The Stewards of High-Value Imaging special collection features a selection of case studies from the Imaging 3.0 library that highlight how radiologists are working with referring physicians and other care partners to improve image ordering through the ACR’s Radiology Support, Communication and Alignment Network (R-SCANTM).


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The medical reimbursement landscape is shifting, substantially affecting how we, as radiologists, practice.

The Medicare Access and CHIP Reauthorization Act of 2015 establishes a new framework, rewarding providers for value over volume and requiring radiologists to present concrete data to illustrate how we are delivering better care to patients at lower cost. In parallel, the Protecting Access to Medicare Act of 2014 requires clinicians to consult appropriate use criteria via a qualified clinical decision support (CDS) mechanism when ordering advanced imaging.

With this transition to value-based care upon us, we, as medical imaging experts, must actively engage our referring colleagues to ensure that each patient receives the right imaging test at the right time for the right reason. The ACR’s Radiology Support, Communication, and Alignment Network (R-SCAN®) is helping us make this transition.

A quality improvement initiative funded by CMS’ Transforming Clinical Practice Initiative (TCPI), R-SCAN empowers radiologists and referring clinicians — in practices large and small — to achieve quantitative improvements in imaging utilization nationwide. A collaborative plan, R-SCAN fosters familiarization with and adherence to the ACR’s Appropriateness Criteria®, CDS technology, and Choosing Wisely® recommendations from various medical societies, including the American College of Physicians, the American College of Emergency Physicians, and the American Medical Association, for a multispecialty approach to improved imaging utilization.

And now, R-SCAN participants can review imaging utilization results across a growing list of imaging areas, indications, and exams through the ACR’s recently launched CDS R-SCAN Registry. Part of the National Radiology Data Registries, this registry will provide national benchmarking data to clinicians, practices, and healthcare systems for imaging utilization comparison with peers. This information can inform the R-SCAN process, which now offers PI CME as one of its many benefits.

To learn more about R-SCAN, I invite you to read the Imaging 3.0® case studies in this issue. As you will see, the momentum for delivering value-based care is strong. Each case study illustrates how radiologists and clinicians are leveraging R-SCAN to achieve significant, quantifiable imaging utilization improvements. And, if you haven’t already, I encourage you participate in R-SCAN as one way to increase your stewardship of appropriate imaging.

Max Wintermark, MDMax Wintermark, MD
Clinical adviser to R-SCAN


Case Studies in this Issue


In Sync

Radiologists and ED physicians use R-SCANTM to bolster their relationship and improve imaging appropriateness for pediatric patients.
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Backed by Guidance

Hershey Medical Center’s R-SCAN™ project decreases inappropriate low back pain imaging and utilization in the emergency department.
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Partners in Quality

With R-SCANTM, radiologists and ED physicians achieve a 45 percent improvement in appropriate CT ordering for PE.
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Homing in on Quality

Radiologists in rural western North Carolina are strengthening their relationships with local physicians and reducing inappropriate imaging via R-SCAN™.
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The Benefits of Collaboration

Radiologists and emergency department physicians partner on an R-SCAN™ project — successfully reducing unnecessary imaging by 52 percent.
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Engaging the Physician

Using R-SCANTM, radiologists collaborate with family medicine clinics to enhance imaging appropriateness of lumbar spine orders.
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Teaching Imaging Appropriateness

A simulation-based educational program increases medical students’ abilities to identify appropriate imaging.

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