Keywords:
Education and training, Economics, Structured reporting, Computer Applications-General, RIS, PACS, Management, eHealth, Computer applications
Authors:
D. J. Vining1, A. Pitici2, C. Popovici2, A. Prisacariu2, M. Kontak2; 1Houston, TX/US, 2Houston/US
DOI:
10.1594/ecr2018/C-2510
Aims and objectives
Medical reimbursements in the United States are transitioning from fee-for-service to pay-for-performance.
The Physician Quality Reimbursement System (PQRS) requires that physicians report quality metrics to data registries to prevent negative payment adjustments [1].
Recently the PQRS system has been replaced by the Quality Payment Program,
but the determination of clinical outcomes remains a core principle in this reimbursement scheme [2].
The American College of Radiology has proposed several Qualified Clinical Data Registry (QCDR) metrics that require radiology-pathology correlation,
but extraction of this information from electronic health records is tedious,
time-consuming,
and costly [3,
4].
Examples of some of the proposed quality metrics that pertain to imaging include the following:
- Quality ID #147: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy. Percentage of final reports for all patients,
regardless of age,
undergoing bone scintigraphy that include physician documentation of correlation with existing relevant imaging studies (e.g.,
x-ray,
MRI,
CT,
etc.) that were performed
- Quality ID #405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions. Percentage of final reports for abdominal imaging studies for patients aged 18 years and older with one or more of the following noted incidentally with follow‐up imaging recommended: (1) Liver lesion ≤0.5 cm,
(2) Cystic kidney lesion < 1.0 cm,
(3) adrenal lesion ≤1.0 cm.
- ACRad #1: CT Colonography True Positive Rate. Percentage of exams with confirming colonoscopies for a ≥10mm polyp detected by CTC (True Positive Rate)
Many of these measures are currently rudimentary but represent harbingers of the future of pay-for-performance.
To assist in the calculation of medical outcomes,
we have developed a structured reporting solution that can report these quality metrics in an efficient and cost-effective manner.