Use of technology that expands access to qualified radiologist leads to earlier diagnosis and treatment of breast cancer

Jan 8 2010

Use of technology that expands access to the most qualified radiologist will lead to earlier diagnosis and treatment of breast cancer, said MedSolutions, a leading provider of medical cost management services.

MedSolutions is speaking out in the wake of controversy surrounding recent recommendations from the U.S. Preventative Task Force, which suggested mammography screenings be limited for women under 50. The guidelines ignited significant debate in the medical community, prompting new recommendations this week from the American College of Radiology (ACR) and the Society for Breast Imaging (SBI) that call for screening to begin at age 40 or earlier in high-risk women.

"With so many groups weighing in on this issue, it is important to keep in mind the primary goal, which is to find the most effective way to identify and treat breast cancer earlier," said Curt Thorne, CEO of MedSolutions. "In addition to ensuring adequate screening, we can more swiftly and accurately detect cancer in women of all ages by leveraging technology to expand access to expertise that yields increased diagnostic accuracy. Such expanded access can also help to eliminate geographic and socio-economic barriers to care."

Studies show socio-economic status and race are major factors in breast cancer survival. Women in low socio-economic areas, including non-metropolitan areas, had the lowest percentage of early-stage cancer and the highest percentage of advanced stages at the time of diagnosis.

MedSolutions speaks from experience. The company offers a diagnostic accuracy solution that uses advanced Clinical Logic(TM) and proprietary workflow technology to identify and route scans to a certified expert radiologist with experience in a particular specialty. Premerus(SM) Diagnostic Accuracy has shown that this approach significantly improves the error rate of misdiagnosis, thus curbing unnecessary treatments and reducing downstream costs. This use of certified expert radiology specialists differs from current practice where, frequently, generalists perform the initial reading and diagnosis. In simple terms, radiology specialists focus on specific anatomic or organ systems, following the established model of specialized medicine, where one would seek a cardiologist or neurologist for treatment related to the heart or brain, respectively.

"There is considerable evidence that diagnostic accuracy in mammography can be significantly improved by using technology to connect patients with experienced radiology subspecialists," said C. Alan Henry, M.D., a former breast surgeon and chief medical officer for Premerus at MedSolutions. "As responsible members of the healthcare system, it is incumbent upon us to do what we can to leverage known best practices in medicine. That means moving away from the current practice of sending scans to the first available radiologist and leveraging technology to ensure that every test is read by an expert 100 percent of the time."

Academic and peer-reviewed research shows that diagnostic experts have more accurate cancer detection rates and provide earlier identification. A mammography study published in Radiology found that radiology specialists have a 30 percent lower recall rate than general radiologists, meaning specialists need significantly fewer additional tests to confirm their screening mammography findings. In addition, these specialists had a 75 percent greater cancer detection rate than that of general radiologists, as well as finding 75 percent more stage 0-1 cancers with screening mammograms. A follow up study in the Journal of the National Cancer Institute confirmed this finding noting that it was the degree of specialization and the volume of experience that increased diagnostic accuracy rates. Physicians who interpreted 2,500 to 4,000 mammograms per year consistently had lower false positive rates.

The Premerus solution is built on this model, leveraging the expertise of radiologists who are fellowship trained and board certified with documented experience in a particular specialty. In addition to meeting American Board of Radiology certification for interpretation in a subspecialty area, they must also pass rigorous testing and an ongoing quality assurance program.

While there is ample evidence to support the merits of subspecialization in radiology, access to a qualified expert continues to be an obstacle for many women. According to the ACR, even radiologists who subspecialize spend only 40 to 60 percent of their time working in that specialty. Additionally, it has been estimated that only about 30 percent of mammograms are interpreted by breast imaging specialists. Using logic and technology to connect patients with certified diagnostic experts not only expands access for patients but also allows radiology subspecialists to spend more time working within their area of expertise.

"More accurate diagnoses obviously reduce the need for, as well as the avoidable risks and costs of, unnecessary follow-up testing and biopsies for many women who would otherwise have false positive screening mammography results," said Norman Scarborough, M.D., a diagnostic radiologist who serves as a vice president and senior medical director with MedSolutions. "But more importantly, greater accuracy and earlier detection improves survival rates and incurs lower overall treatment costs for those diagnosed with cancer."

In an independent analysis, Premerus was shown to yield significant reductions in healthcare costs. A cost analysis validated by the actuarial firm Thomson Reuters indicated that Premerus could save healthcare payors $4.45 per member per month by reducing downstream costs associated with misdiagnosis. This translates to savings of approximately $16 million per year for an average-sized health plan.

"Our methodology has been independently validated to definitively show that using Certified Premerus Expert diagnostic radiology specialists can yield billions of dollars in annual savings for the health care system," stated Thorne. "Of even greater importance is the fact that diagnostic accuracy assures patients more rapidly receive the appropriate care they need."