Brigham and Women's Hospital (BWH) was selected by the Centers for Medicare & Medicaid Services (CMS) as one of five conveners of a demonstration project that promotes appropriate utilization of advanced imaging services, CMS announced February 2, 2011. BWH was selected as a convener under the Medical Imaging Demonstration (MID) along with Henry Ford Health System; Maine Medical Center-Physician Hospital Organization; University of Wisconsin Hospital Foundation, and National Imaging Associates.
The BWH proposal to CMS was submitted on behalf of a consortium consisting of BWH, University of Pennsylvania School of Medicine and the University of Pennsylvania Health System, Philadelphia, PA, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY (Cornell) and Geisinger Health System, Danville, PA (Geisinger). This consortium recruited academic and non-academic physician practices employing more than 5,000 physicians and other ordering providers across the full spectrum of medical specialties (including primary care, cardiology, rheumatology, orthopedics, general surgery, neurosurgery, neurology and many other specialties). The participating practices serve patients in urban, suburban and rural settings in New York, Pennsylvania and Massachusetts. These patients are very diverse, representing all major demographic characteristics of the populations in those states.
"The size, geographic reach and diversity of our consortium will allow us to gather and provide to CMS a wealth of data on the impact of decision support systems on the appropriate use of advanced medical imaging services," said Robert J. Min, M.D., M.B.A., Chairman of Radiology at Weill Cornell Medical College.
The two year demonstration will assess the impact of decision support systems used by physicians on the appropriateness and utilization of advanced medical imaging services (MRI, CT and nuclear medicine) ordered for fee-for-service Medicare beneficiaries. "The use and cost of advanced medical imaging services have increased over the past decade," noted John F. Cardella, M.D., Chairman of Radiology at Geisinger. "The Medicare Imaging Demonstration project will help us examine whether providing information on the appropriateness of imaging to ordering physicians at the time they are making their clinical decisions affects the utilization of advanced imaging services."
Each recruited practice has agreed to utilize a decision support system provided through Medicalis Corporation (San Francisco, CA) and General Electric Healthcare (London, UK) to order all targeted advanced imaging procedures in the MID for Medicare fee for service beneficiaries and to provide to CMS the data required under the MID. "The CMS MID is an ambitious and critical undertaking," said Oran Muduroglu, President and CEO of Medicalis. "We are excited to play a role in this groundbreaking project with these outstanding institutions."
"GE Healthcare is committed to using the power of healthcare information technologies to improve the quality of care and reduce waste. We are pleased to support the physicians and health systems participating in the Medicare Imaging Demonstration," commented John Dineen, President and CEO of GE Healthcare.
The decision support provided to physicians will consist of guidelines created by several professional medical societies, including the American College of Cardiology, the American College of Physicians and the American College of Radiology. The source and strength of each guideline will be transparent to the ordering physician and will assess the appropriateness of the advanced imaging request (appropriate, inconclusive/ uncertain or not appropriate), or suggest alternative tests when relevant. All of the physicians in each practice have agreed to participate in the MID and to cooperate with the evaluation process to be performed by the Rand Corporation (under contract with CMS).
"The members of the consortium felt it was important to participate in the MID" explained Curtis Langlotz, MD, PhD, Vice Chair for Informatics, Department of Radiology at University of Pennsylvania. "Our goal is to provide extensive, high quality data to guide health policy decision makers while at the same time improving the quality of care we deliver to our patients."
Ramin Khorasani, M.D., MPH, Vice Chair for Quality, Safety and Informatics, Department of Radiology at BWH, expanded on Dr. Langlotz sentiments. "Beyond the Medicare Imaging Demonstration project, the common decision support platform of our consortium will enable our researchers to design large multi-center comparative effectiveness studies and implement evidence-based interventions aimed at improving the appropriate use of medical imaging," Dr. Khorasani said. "We hope to utilize our consortium to work with national, regional and local organizations to pursue research that promises benefits for our patients and our healthcare system."
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