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Quality Measures in Radiology

By Jim Knaub

Imaging departments and radiology practices have been convincing referrers, payers, and patients of their quality for a long time, but measuring that quality is a different matter.

“Quality is the subjective measure of the delivered product or service,” consultant Bob Maier, CPA, told his audience at AHRA’s annual meeting last month. Maier, CEO of Tennessee-based Regent’s Health Resources, discussed how radiology departments and groups need to analyze and adjust how they do business as health care reform ushers in the dawning age of accountable care.

Exactly how reform’s focus on quality and outcomes will develop isn’t clear. Maier defined outcomes as “the measure of the effective utility of the product or service.” He, and the people I spoke with at AHRA, do not anticipate any government-driven quality definition. It will fall to imaging organizations to develop and track their own measures and to use them as tools to provide care and promote their services to the evolving accountable care organizations.

In that light, he presented the following list of what he called “progressive measures of medical imaging quality” for imaging organization leaders to discuss when developing their own quality measures:

• automated exam appropriateness evaluation;
• the correct test performed the first time, every time;
• appropriate communication with referrers and patients;
• having all previous images available for comparison from any location;
• immediate and accurate interpretation (prompt, appropriate turnaround time);
• subspecialized interpretation;
• immediate report transmission to the treatment team;
• making the radiologist a member of the patient care team and having him or her be available to communicate with referrers;
• imaging assists in accelerating the treatment plan;
• making the cost of exam readily identifiable;
• identifying any additional exams required;
• including an evaluation of history and physical exam with comparative exams; and
• appropriately using computer-aided diagnosis.

Quality imaging organizations already incorporate at least some of these factors into their imaging services. The challenge facing leaders is developing measures for these aspects of their imaging services and using them to compete in the consolidating imaging market.

— Jim Knaub is editor of Radiology Today.