Radiology has become a much more complex environment than it was just a few years ago. It now encompasses CT scans, MRI’s (and MRA’s), diagnostic mammography, bone scans, thyroid scans, thallium cardiac stress tests and PET scan imaging. This makes it imperative that communications improve between the ordering physician and imaging facilities.
Those are the views of our own Dr. Katherine Gray, PhD, the president of Sage HMS. The publication Radiology Today recently published her article on this topic.
Katherine writes that there is nothing like a deadline to focus the mind. She points out the use of clinical decision support (CDS) will be mandatory on January 1, 2021 for all Medicare patients receiving outpatient advanced imaging.
That means that a standard process must be in place for each ordering physician to document the specifics of the patient’s clinical symptoms, with recommendations based on medical literature as to the most appropriate procedure. The Centers for Medicare & Medicaid Services has recognized CDS solutions as a mechanism that is qualified to provide evidence-based imaging recommendations supported by appropriate use criteria.
Like many other industries, healthcare can take advantage of advanced technology to meet these types of mandates for greater efficiency. Katherine talks about the increasing use of algorithms based on artificial intelligence (AI) to assist the imaging process. Not only can AI help to more accurately predict when imaging is necessary, it can also extract value from images that come back negative for the tested condition.
AI algorithms can review a negative finding and search for similar phrasing in research data, extracting and categorizing information for easier consumption with 95% accuracy. This produces a “trail of breadcrumbs” to caregivers, enabling better care and, potentially, identifying the need for additional testing. Over time, this type of data collection as part of treatment will also improve the clinical processes and quality of care.
This use of AI algorithms is a logical extension of existing CDS tools, like Sage HMS’s industry leading Radwise solution. RadWise is a CMS qualified Clinical Decision Support Mechanism (qCDSM) that gives providers the ability to consult robust, evidence-based knowledge for diagnostic imaging and receive appropriate use criteria (AUC) recommendations to meet CMS regulations for claims payment.