Project Manager – Cerner Integration Specialist

Project Manager – Cerner Integration Specialist

Reports To: Director of Implementation

Location: Remote – Telecommute (No travel required) preferred location in Madison, WI.

Job Summary:

National Decision Support Company is an early stage healthcare IT company specializing in the delivery of Clinical Decision Support content to health care organizations, radiology practices and health plans. We are seeking an individual to join the implementation team to help drive installs with our customers on the Cerner EHR platform and ensure their ongoing success.  The successful candidate will need to demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks could be outside of the core function. This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Primary responsibilities include:

  • Establish and maintain strong relationships with customers
  • Work with customers to develop and manage their implementation plan and timeline
  • Customize product configuration/set up to meet the needs of the customer
  • Identify and resolve issues that arise throughout the implementation
  • Work closely with other areas including product development and sales to ensure customer needs are met
  • Work with the implementation team to continue to improve implementation tools and process

Minimum Qualifications:

  • Bachelor’s degree or greater
  • A history of academic and professional success
  • Strong project management skills
  • Strong customer service skills and backgroun
  •  Excellent verbal, written, interpersonal and presentation skills
  • Detail oriented

Preferred Qualifications:

  • 2+ years of project management experience; with demonstrated ability to manage complex, multidisciplinary projects
  •  2+ years of healthcare IT experience
  • 2+ years of experience with the Cerner EHR platfom
    •  MPage and CCL experience preferred
  • Proficiency with Microsoft Excel

Clinical Content Analyst

Clinical Content Analyst
Reports to: 
VP Technology

Location: Telecommute

Job Summary:

National Decision Support Company (NDSC) is currently seeking an individual to contribute to our content curation process. Help NDSC take nationally-recognized, evidence-based clinical decision support guidelines and make them actionable in the provider workflow. This includes working with medical specialty societies, such as American College of Radiology (ACR) and American College of Cardiology (ACC), physician leadership and NDSC customers during sales, implementation and post-live phases to ensure successful outcomes. You will work together with other teams across all areas of the company to achieve customer success. Your success will have a direct effect on healthcare organizations improving patient care.

The successful candidate will need to demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks could be outside of the core function. This position will provide the successful candidate with personal development opportunities in a rapidly growing company.

Principal Responsibilities:

  • Manage relationships with clinical content sources, including medical specialty societies such as the ACR and ACC.
  • Curate and maintain clinical content repositories
  • Design, plan and complete clinical content related projects
  • Create clinical content understanding data structures and workflows for quality delivery
  • Coordinate clinical content update and changes within overall product management
  • Identify opportunities and implement solutions to clinical content management processes
  • Work closely with other teams including product development, implementation and support to ensure customer needs are met

Minimum Qualifications:

  • 1+ years of healthcare provider experience (ex. Technician, RN, NP, etc)
  • Associates’ degree or greater

 

Preferred Qualifications:

  • 2+ years of healthcare IT experience
  • Electronic Medical Record (EMR) experience

About Us:

National Decision Support Company is a rapidly growing healthcare IT software company who is passionate about making healthcare smarter.  Our solutions help providers make educated decisions that improve patient care and evaluate cost effectiveness.  We have a start-up atmosphere and a youthful mentality but the market demand and stability that exceeds our age.  Our customers include some of the most prestigious hospitals in the country and are currently expanding into Europe.

contact: hr@nationaldecisionsupport.com

Software Engineer in Test

Job Title:  Software Engineer in Test

Reports to:  Director of R&D

Location:  Madison, WI or Remote – Telecommute

Job Summary:

Early stage Healthcare IT Company specializing in delivery of Clinical Decision Support content to healthcare organizations and health plans.  Seeking new team member who can fulfill the quality related responsibilities of a cross-functional, agile software development team.

As a Software Engineer in Test you will be a key member of the R&D team who will be actively developing automated tests against our entire stack with individuals who are smart, and love what they do.  Serious candidates will be passionate about creating great software in a team-oriented, agile environment and able to demonstrate the ability to own and manage testing responsibilities of our products, working with both engineering and product teams.

This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Principal Responsibilities:

  • Build and maintain automated test projects.
  • Create test cases, test plans, and specifications as well as creating or acquiring test data sets.
  • Actively participate as a member of an agile development team and help the team deliver the highest quality products.
  • Work closely with engineers, product owners, and sales staff to create comprehensive feature requests, test plans, as well as contribute to internal and client documentation.
  • Develop standard testing and quality practices.
  • Drive the creation and maintenance of regression tests.
  • Increase functional test coverage by both expanding existing coverage, as well as creating new test suites.

Minimum Qualifications:

  • Two years of experience in testing web services and web applications.
  • Ability to think critically and understand complex systems.
  • Quick learner with high attention to detail.
  • Ability to perform root cause analysis and help triage issues.
  • Strong interpersonal, problem-solving, and documentation skills.
  • Passionate team member eager to collaborate to create great software.

Nice to have Qualifications:

  • Experience in the medical IT field.
  • Experience understanding relational data models, and writing SQL against relational databases
  • Knowledge of QA best practices and testing methodologies.

Trickle-Down Economics of Medical Imaging

Trickle-Down Economics of Medical Imaging

Saurabh Jha, MBBS, MRCS

February 05, 2015

Medical Imaging and the Price of Corn

After the Napoleonic wars, the price of corn in England became unaffordable. The landowners were blamed for the high price, which some believed was a result of the unreasonably high rents for farm land. Economist David Ricardo disagreed.

According to Ricardo, detractors had the directionality wrong. It was the scarcity of corn (the high demand relative to its supply) that induced demand for the most fertile land. That is, the rent did not increase the price of corn. The demand for corn raised the rent. Rent was a derived demand.

Directionality is important. Getting directionality wrong means crediting the rooster for sunrise and blaming umbrellas for thunderstorms. It also means that focusing on medical imaging will not touch healthcare costs if factors more upstream are at play.

Medical imaging is a derived demand. The demand for healthcare induces demand for imaging. Demand is assured by the unmoored extent to which we go for marginal increases in survival.

The Demand for Imaging in Stroke

The treatment of ischemic stroke using thrombolytics and intra-arterial therapy (IAT) is instructive on how imaging can be induced. Lytics improve outcomes but must be administered relatively rapidly after onset of symptoms. IAT, which is treatment at the site of arterial blockage, allows the clock to tick for a bit longer and has recently been shown to be beneficial.

In the MR CLEAN[1] study, patients with acute ischemic stroke with radiographically proven occlusion in the proximal anterior circulation were randomly assigned to IAT or usual care. IAT included local thrombolysis, mechanical break up of thrombus, or stent placement. In both treatment and control groups, most patients also received thrombolysis with alteplase (Activase®).

The results published in the New England Journal of Medicine [1] showed that patients who received IAT within 6 hours of stroke onset had a clinically significant increase in functional independence at 3 months without higher mortality.

Counting the CTs and CT Angiograms

However, patients don’t walk into the emergency department saying, “Good evening, doctor, I have an occlusion in the proximal internal carotid artery. Can we get moving, please?” Sometimes they have classic signs and symptoms of stroke in the distribution of the target artery. Often they have more vague signs and symptoms that could be due to other causes.

Thrombolytics aren’t candy that you distribute willy-nilly. They have serious side effects such as bleeding in the brain. They can worsen the neurologic deficit. They can kill, even when used correctly.

Patients first need a CT of the head—not to pick up early stroke; that’s a clinical diagnosis. A CT is done to make sure that the stroke is not caused by a bleed. Hemorrhagic strokes are less common than ischemic strokes but common enough to warrant routine use of CT for this distinction.

The other reason for CT is to ensure that if the stroke is indeed ischemic, there is not so much brain edema that thrombolysis will lead to bleeding. The risk for bleeding in an ischemic stroke increases in edematous brains.

For IAT, we need to know who has a treatable lesion. Signs and symptoms don’t tell us with certainty who has a culprit lesion in the proximal internal carotid arteries, and neither does standard CT of the head. Patients need CT angiogram not only to identify those who have a treatable blockage but also to find out who doesn’t have a treatable lesion. We can’t tell this without doing a CT angiogram.

Obviously, this means that more patients will get a CT angiogram than are eligible for IAT. Many more will get a CT angiogram than will actually benefit from IAT. (Not everyone deemed to benefit from IAT will actually benefit.)

Okay, so CT of the head is done in all, and CT angiograms are done in many. Is it time to check out with the radiology cashier? No. We are far from done with imaging.

Imaging for Complication Monitoring

After thrombolysis, patients will have another CT of the head to make sure that the clot buster did not cause a bleed. They will be managed in the neuro-intensive care unit (ICU). The level of care will be higher. The sensitivity to mild variation in objective ICU parameters will be intense. Surveillance CTs of the head will be frequent.

There is a plausible risk for bleeding elsewhere after thrombolysis, such as in the abdomen. How do we know whether the patient has bled? Signs and symptoms aren’t reliable. Remember, these patients have neurologic deficits, which bar some from verbalizing clearly.

A fall in hemoglobin and hematocrit could herald a bleed, even if more often than not these indices fall because of the fluid status. Patients in whom these indices have dropped may need a CT of the abdomen to look for bleeding. The cheaper noncontrast CT will suffice in most but not all patients. Some may have active bleeding warranting interventional radiology, which requires a CT angiogram for diagnosis.

IAT involves a puncture of the femoral artery and then navigation of a catheter through the aorta, which is not without complications such as seroma, which may resolve spontaneously. Less commonly, patients might develop a false aneurysm of the femoral artery or an arteriovenous fistula. Patients need an ultrasound and/or CT or MR angiogram of the femoral arteries when there is suspicion of dangerous complications.

The aorta and carotid arteries are tricky territories to navigate. The surgeon might tear the arterial wall. The tear might propagate. These patients need a CT angiogram of the chest and neck. The surgeon might feel that he or she was a bit too enthusiastic breaking up the clot and fear that the artery has been torn. These patients will get a CT angiogram as well. Better safe than sorry.

Broken thrombus could embolize and infarct new areas of the brain, causing new neurologic deficits. In those instances, an MRI of the brain, a CT angiogram of the head, or, more likely, both may be ordered. Of note, in the treatment arm of the MR CLEAN trial, new strokes were reported in 13 of 233 participants.

We are not yet done with imaging.

The CT dye load and natural variation may elevate the creatinine, prompting an ultrasound of the kidneys to exclude a postobstructive, and treatable, renal impairment. Patients will receive countless chest and abdominal x-rays when support lines are inserted and manipulated, in accordance with principles of safety.

A few CTs of the chest may be ordered because a radiologist could not “exclude pneumonia with absolute certainty” in someone with left partial lung collapse, which everyone in the hospital has, particularly when an intern puts in the clinical information, “new fever, exclude pneumonia, kindly.”

Cost and Quality Considerations

Stroke doesn’t sleep at night, and neither do its costs. Radiology departments must be staffed to provide timely access and reports. CT angiograms are complex studies. Trained radiologists, and perhaps expert 3D technologists, must be available 24/7. The window for IAT is 6 hours from stroke onset—the urgency at 5 hours, 30 minutes will be intense.

The medical imaging consequent to applying thrombolysis and/or IAT for stroke in practice is substantial. Any other industry would proudly showcase this exemplar of trickle-down economics. However, patients don’t pay large marginal costs for small marginal benefit. The costs are diffused. But costs are costs. Healthcare is neither a free market nor a market that is free.

How should payers reimburse the derived demand for imaging? They can say: “Stroke team, here is how many quality-adjusted life years (QALYs) the population gained. Thanks for your contribution, radiologists. Here is your share. Yes, I know it isn’t a lot, and your efforts were enormous, but you must admit, the net QALYs are a bit modest.”

That is if the absurdly but rationally high amount of medical imaging as a result of thrombolysis/IAT for stroke were reimbursed in a bundled payment for stroke. This is fine, but is it fair that the average returns on imaging are diminished because of increasing complexity of treatment and diminishing returns on QALYs, factors over which radiologists have little control?

Or should radiologists say to payers, “You want to improve survival in stroke patients using aggressive, expensive, and dangerous therapy. Here is an estimation of the costs of the imaging. Now put your money where your coverage is.”?

Regardless of the payment method, whether bundled pay for outcomes such as QALYs or itemized fee for service, it should be apparent that thrombolysis and IAT for stroke will substantially increase use of imaging. But imaging should not be blamed for increasing costs; that credit should be given to science and humanity for the high costs of stroke treatment.

When clot busting for stroke becomes practice du jour, the population will no longer resemble the trials. The MR CLEAN study was conducted in The Netherlands. This is the United States. Patients will be older and sicker; they will incur more complications, induce more imaging, and derive even less treatment benefit, statistically speaking. Any bundled payment determined by outcomes will become smaller with more and more activity in the bundle. The math of such a payment scheme can’t last for too long.

References

  1. Berkhemer OA, Fransen PS, Beumer D, et al; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11-20. Abstract

EHR Clinical Decision Support Functions Linked to Better Care Quality | Blue Horseshoe Blogger

EHR Clinical Decision Support Functions Linked to Better Care Quality

Article

EHR Clinical Decision Support Functions Linked to Better Care Quality

California Healthline, iHealthBeat, Monday, November 3, 2014

Meaningful use standards that require clinical decision support functions could significantly improve quality of care, according to a study published in the American Journal of Managed CareHealth IT Analytics reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

Details of Study

For the study, researchers analyzed data from the 2006 to 2009 National Ambulatory and National Hospital Ambulatory Medical Care surveys on adult primary care visits to practices that met the requirement for Stage 1 of the meaningful use program. These practices had EHR systems with at least one of five CDS functions:

  • Electronic problem lists;
  • Lab result reports;
  • Notifications for out-of-range labs;
  • Reminders for preventive care; or
  • Warnings for drug interactions.

The researchers then divided the visits into three categories:

  • Visits to practices with all CDS functions enabled;
  • Visits to practices with at least one CDS function disabled; and
  • Visits to practices with at least one missing CDS function (Bresnick,Health IT Analytics, 10/31).

Please click below to continue reading…

Findings

The study found that 86% of patients who visited primary care clinics with all five types of CDS functions had controlled blood pressure, compared with 82% of patients who visited clinics with at least one missing function and 83% of patients who visited clinics that had disabled at least one function.

Further, researchers found that:

  • CDS functions were associated with blood pressure control and fewer visits for adverse drug events;
  • CDS functions were associated with better performance on indicators of quality of care and clinical decision support functions related to such quality measures (Mishuris et al., AJMC, 10/28); and
  • Decisions to disable CDS functions were associated with reduced quality of care improvements (Health IT Analytics, 10/31).

However, the researchers said they were unable to determine an association between disabling particular CDS functions and cancer screening, health education or influenza vaccinations because of limited data (AJMC, 10/28).

Implications

The researchers said, “Overall, meaningful use standards that include [CDS functions] appear to have a significant positive effect on some national quality-of-care indicators and health outcomes.”

They added, “It will be important to evaluate the evolving impact of meaningful use as the stages continue to be more widely implemented and better integrated with care processes; we anticipate further gains in healthcare quality indicators and outcomes as a result” (Health IT Analytics, 10/31).

Source: iHealthBeat, Monday, November 3, 2014

CDS functions within the EHR have shown the ability to improve the quality and safety of patient care. I personally feel that these functions serve as a safety net for providers and can help catch potential errors before they are made.

What are your thoughts on CDS functions, and do you feel it is appropriate for practices to have the option of disabling any of the CDS functions available?

Thanks for reading and please share your thoughts!

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Emergency departments continue to drive CT use

Emergency departments continue to drive CT use

By Eric Barnes, AuntMinnie.com staff writer

November 11, 2014 — Bucking an overall downward trend in utilization of advanced imaging services, emergency departments (EDs) are still seeing growth in imaging, especially in CT use, which has tripled over the past decade, according to a new article in the Journal of the American College of Radiology.

Researchers from Thomas Jefferson University (TJU) looked at emergency department utilization of imaging tests from 2002 through 2012, parsing Medicare Part B data to determine the frequency of imaging exams by modality. They found that x-ray and CT were the most widely used modalities in the ED, and both rose over the decade, though x-ray’s ascent has been slower: Radiography use rose by more than one-fourth, but CT utilization nearly tripled (JACR, November 2014, Vol. 11:11, pp. 1044-1047).

“Imaging rates in every modality nationwide at all venues where imaging is done have flattened out or started to come down,” lead author Dr. David C. Levin, professor emeritus of radiology at TJU, told AuntMinnie.com. “The emergency department is the only place where imaging rates have continued to go up, and this paper shows they’re going up in every modality, especially plain films and CT.”

Rising imaging use soon halted

At the turn of the 21st century, imaging was the fastest-growing segment among all physician services. But the growth alarmed policymakers and payors, and within a few years various techniques were adopted to control utilization.

Dr. David C. Levin

Dr. David C. Levin from Thomas Jefferson University.

Steps to curb imaging ran the gamut and included reimbursement cuts, code bundling and higher deductibles, co-payments for patients, and computerized decision support, Levin and colleagues wrote.

On the whole, the effort has been a success. Growth in advanced imaging has all but stopped or has even reversed, the authors wrote. But imaging occurs in four kinds of service venues: hospital outpatient facilities, private offices, hospital inpatient facilities, and emergency departments. And little research has been done to ascertain precisely where the changes in imaging rates have occurred.

A previous study did show, however, that imaging rates were rising in emergency departments through 2008.

“The feeling among some radiologists at present is that although overall imaging utilization is flat or showing a decline, its use in the ED may be continuing to increase,” Levin and colleagues Dr. Vijay Rao and Laurence Parker, PhD, wrote. “In this study, we extend the review of ED imaging trends through 2012 and attempt to determine if this impression is correct.”

Data came from Medicare Part B Physician/Supplier Procedure Summary Master Files from 2002 through 2012. The files cover all services to 36.9 million beneficiaries in the Medicare fee-for-service population, but not the nearly 14,000 inMedicare Advantage plans.

Exam volume, location, place of service, and specialty provider were all included; the researchers grouped every code by modality for plain radiography, CT, noncardiac ultrasound, MRI, and nuclear medicine. Interventional codes were excluded. Rates were calculated per 1,000 beneficiaries, and ED trends were compared with non-ED trends.

The researchers found that x-ray use rose slowly and steadily between 2002 and the end of 2012, from 248.7 exams per 1,000 beneficiaries to 320 exams per 1,000.

Over the same decade, CT use rose rapidly every year except for a one-year decline in 2011, resuming its rise in 2012. During the entire study period, CT rose from 57.2 exams per 1,000 beneficiaries to 147.9 exams in 2012 — growth of 158%.

“In 2011, instead of going up, [CT] went down,” Levin said. “That was an artifact of code bundling in CT of the abdomen and pelvis.”

Even ultrasound use increased over the decade, though it rose considerably less than x-ray and CT, increasing from 9.5 exams per 1,000 beneficiaries in 2002 to 21.0 in 2012, for a growth rate of 121%. Ultrasound was not burdened by code bundling.

Finally, the utilization rate for nuclear medicine fell from 2.8 exams per 1,000 beneficiaries to 2.1 in 2012, a drop of 25%, largely due to code bundling in myocardial perfusion imaging.

ED imaging exam rates per 1,000 Medicare beneficiaries
Exam 2002 rate per 1,000 2012 rate per 1,000
CT 57.2 147.9
Plain radiography 248.7 320.0
Ultrasound 9.5 21.0
MRI 1.4 5.1
Nuclear medicine 2.8 2.1

Why the spike in CT use?

“The ED has become very crowded and busy; I think the ED doctors are under a lot of pressure to turn patients around, and they know CT is a good tool to make accurate diagnoses and make a disposition of the case to discharge the patient when they want a definitive diagnosis,” Levin said. “I don’t fault them for that — they’re under the gun.”

In cardiac imaging, for example, multiple studies have shown that a negative coronary CT angiography (CCTA) exam means that chest pain patients can be safely discharged if they do not have evidence of significant stenosis.

“I think those studies are right on the mark,” Levin said. “Every chest pain patient who walks in where there’s any kind of clinical suspicion for that should immediately go for CCTA right off the bat,” he said. “If they get a CT scan, the ED physician will know immediately if they have something serious.”

The scan length can, of course, be extended to a triple rule-out exam when there is also suspicion of aortic dissection or pulmonary embolism, and it will reveal any other cause of chest pain that might be present, such as pleural effusion or pneumothorax, Levin said.

What about overuse?

Medicare data show that in 2012, 18.4 million imaging studies were performed in emergency departments, constituting 14% of all Medicare fee-for service imaging, the authors wrote.

It is concerning that imaging rates continue to grow, and the results suggest that radiologists should work more closely with their ED colleagues to exert tighter control over imaging utilization.

The solutions include more diligent application of clinical rules for imaging, such as the Wells criteria for suspected pulmonary embolism, or the Canadian C-spine rule for cervical spine trauma, the authors wrote. ED physicians should be better educated about American College of Radiology (ACR) appropriateness criteria, and cooperation between radiologists and ED physicians should be better tailored to emergency or trauma situations.

Use of computerized clinical decision support will also be helpful, along with greater familiarity among radiologists and ED physicians with exams that are potentially unnecessary or overused according to the Choosing Wisely initiative.

But while Levin said he is sure there are instances when CT is overused in the ED, he doesn’t think of it as a global problem.

“I think, in general, recognizing the fact that ED docs have been really under the gun, they’ve been swamped with more and more patients, and there’s always the fear of malpractice liability lurking in the shadows, we have to be sympathetic,” Levin said.

In any case, the 2013 data will be out within a month, and it will be interesting to see if current trends continue, he said.

CT, MRI use declined in ED after 2007, August 20, 2014

Study shows combined thoracic CT use has dropped, August 14, 2014

Study tracks ebb and flow of imaging use in private sector, May 20, 2014

Outpatient echo code bundling has unintended effects, May 15, 2014

Radiologists hit hard by CT code bundling, April 29, 2014


Copyright © 2014 AuntMinnie.com

Does malpractice reform affect defensive medicine practices? | Medical Economics

Does malpractice reform affect defensive medicine practices?

Study looks at physician behavior in emergency departments before, after reform legislation

Physicians and health policy experts have long assumed that doctors are driven to practice defensive medicine because they fear being sued for malpractice. But a recent study of what happened in states that made it more difficult to sue some physicians casts doubt on that assumption.

The study examines the impact of changes in the behavior of emergency department (ED) physicians following the reform of malpractice laws in in three states: Texas, which in 2003 changed its malpractice standard for emergency care to “willful and wanton negligence;” and Georgia and South Carolina, which changed their standards to “gross negligence” in 2005.“From a legal standpoint, these two standards are considered synonymous and are widely considered to be a very high bar for plaintiffs,” the study’s authors write.

Malpractice insurance: Understanding the importance of coverage limits

The researchers looked at the numbers of computed tomography and magnetic resonance imaging procedures and inpatient admissions ED physicians ordered for a random sample of Medicare fee-for-service patients in the three states between 1997 and 2011. They focused on the imaging procedures because ED physicians frequently self-report them as examples of defensive medicine practices. Researchers also studied per-visit charges as a proxy for the intensity of the level of services provided to the patients.

The authors then compared patient-level outcomes before and after passage of malpractice reform both among the three reform states and in surrounding states, with the goal of isolating the specific impact of the reform legislation from other trends and from patient characteristics. The goal was to arrive at what the authors term “policy-attributable changes” in ED physician behavior.

After subjecting the data to regression analysis, the researchers found no decrease in rates of CT or MRI use or hospital admission in any of the three reform states, and no reduction in per-visit charges in Texas or South Carolina. Georgia experienced a 3.6% reduction in per-visit charges.

The authors note that ED physicians frequently cite the use of advanced imaging as example of a defensive medicine practice. “Our results challenge the validity of these assertions, or at least suggest that the use of emergency department imaging is unlikely to be affected by malpractice reform alone,” they write.

READ: Competition driving malpractice premiums down

Although the study focused on ED physicians, the results have wider implications for the debate over shielding doctors from malpractice suits would reduce defensive medicine practices, and thereby reduce the nation’s overall medical costs, says Daniel Waxman, MD, PhD, the lead author and an adjunct natural scientist at the RAND Corporation. “People have said over and over that malpractice reform is an important way to save money, and I think the interesting part of this study suggests that’s a blind alley,” Waxman says.

The study, “The Effect of Malpractice Reform on Emergency Department Care,” appears in the October 16 issue of the New England Journal of Medicine.

DOTmed.com – European Society of Radiology calls for safer and more appropriate use of imaging

ESR calls for safer and more appropriate use of imaging

by Lauren Dubinsky , Staff Writer
The European Society of Radiology announced earlier this week that it launched a “Call for Action” as part of its EuroSafe Imaging campaign that began in March. ESR started the campaign in an effort to reduce the increasing number of radiological exams that are conducted every year.

“This initiative is necessary, but also is very timely, because we are now facing, worldwide, a challenge to deal with the potential risks of radiation in health care without compromising the benefits, and this is the reason why I think it is very appropriate that this initiative is taken by the professionals; the radiologists,” Dr. Maria Del Rosario Perez of the World Health Organization, said in a statement.

The campaign backs the Bonn Call for Action that the WHO and the International Atomic Energy Agency launched in 2012, which is a proposal for the priorities that stakeholders should focus on regarding radiation protection in the medical industry for the next decade.

The “Call for Action” consists of 12 points that include advocating for the appropriate use of imaging, ensuring that radiation doses are within diagnostic reference levels, utilizing the “as low as reasonably achievable” principle, promoting the use of the latest equipment, empowering patients and teaming up with other stakeholders.

The ESR has already started making headway by working on introducing a new clinical decision support system for imaging referral guidelines. It will be a software tool that will help referring physicians recommend the most appropriate radiological exams for their patients.

The society is also working on developing templates for internal clinical audit. They already offer e-learning resources on radiation protection and special education sessions as well as the Patient Advisory Group for Medical Imaging to empower patients.

“We believe that this holistic approach is an important step towards joining forces for patient safety in Europe,” Guy Frija, founder of EuroSafe Imaging, chair of the EuroSafe Imaging Steering Committee and ESR past president, said in a statement. “And we believe too that the use of up-to-date equipment is of utmost importance for improving the safety of X-ray examinations. The ESR urges the European Commission to develop a European plan for the improvement of X-ray equipment, including CT across Europe.”