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Five regional health systems in Minnesota and the state’s five largest medical payers have launched an initiative designed to reduce the number of unnecessary high-tech diagnostic imaging exams.

At the heart of the plan is a “clinical decision-support tool” called RadPort, from Nuance Communications of Burlington, Massachusetts, that can either be accessed via a Web site or embedded in an electronic medical records system.

The physician ordering a scan doesn’t have to call a radiology benefits management company. Instead, the doctor enters the patient’s indications into the tool and selects the imaging procedure he or she wants to order. Based on criteria from the American College of Radiology and subspecialists at Massachusetts General Hospital, an on-screen display ranks the proposed procedure on a scale from 1 (low utility) through 9 (indicated). If the tool thinks the procedure would be of low or marginal utility, it suggests alternative procedures.

From the time the physician finishes entering the information, the process takes seven to ten seconds, according to Scott Cowsill, senior product manager of diagnostic solutions with Nuance. He was interviewed by DOTmed News.

The doctor can still order a scan rated as low utility but must enter a justification.

The Institute for Clinical Systems Improvement (ICSI) organized the initiative. ICSI is a nonprofit organization based in Bloomington, Minnesota, and focused on improving health care. It offers a more complete explanation of the program through its Web site.

The participating health systems are Allina Medical Clinic, Fairview Health Services, HealthPartners Medical Group, Park Nicollet Health Services, and St. Mary’s/Duluth Clinic Health System. The health plans are BlueCross BlueShield of Minnesota, HealthPartners Health Plan, Medica, UCare, and the Minnesota Department of Human Services plan.

ICSI tested the initiative in a yearlong pilot program that ended in 2008. It proved successful enough that the five medical groups have continued using the tool even after the end of the pilot program. ICSI says the pilot demonstrated a 10 percent improvement in the diagnostic utility of scans ordered compared with scans ordered through a radiology benefits management company. The program also held high-tech diagnostic imaging (HTDI) claims steady at no increase from 2007 to 2010 following an annual increase of 8 percent from 2003 through 2006 and saved an estimated $84 million in reduced claims filed, according to ICSI.

“Use of HTDI procedures such as MRI, CT, PET, and nuclear cardiology tests has been increasing 8 percent annually in Minnesota, and more than $100 billion is spent each year on diagnostic imaging nationally,” said Cally Vinz, vice president of clinical products and strategic initiatives with ICSI. “Yet there have not been enough studies to correlate this increase with improved patient outcomes.

“Our goal with this initiative is to ensure the appropriate use of HTDI exams based on the medical evidence so that patients get better care, providers are more efficient, and health care is more affordable.”

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One Response to “Minnesota Plan Aims To Cut Unneeded Scans”

  1. Radiology Daily»AlertArchive » Bill Would Make Docs Justify Imaging Orders on December 16th, 2013 at 11:09 am

    […] reported on the Minnesota initiative three years ago. An ordering physician enters patient information and selects an imaging procedure. […]