"While reading out several lumbar spine MRI studies, I've encountered more than the fair share of patients being imaged and reimaged with the same symptoms and signs," said senior study author Dr. Christie Lincoln of the Baylor College of Medicine in Houston. "And I asked myself, 'Am I positively impacting the care for each of these patients, or is there some element of waste?' "
Lincoln and former Baylor neuroradiology fellow Dr. Melissa Chen found a Choosing Wisely topic on R-SCAN for reducing inappropriate ordering of imaging for low back pain, and several radiology residents -- including Drs. Kevin Wang, Darshan Variyam, and Christopher Yen -- were recruited to participate in the project.
Family medicine physicians at Harris Health - Baylor College of Medicine were receptive to the overture for constructive collaboration. Three clinics received educational presentations that highlighted the imaging guidelines from the American College of Physicians and Choosing Wisely for lower back pain, as well as R-SCAN and its clinical decision-support features. The initiative led to a significant drop in the number of lumbar spine MRI scans ordered per clinic, and it also resulted in an increase in the mean ACR Appropriateness Criteria rating for the orders.
In keeping with today's healthcare focus on quality and lower costs, radiology must emphasize reducing unnecessary tests and generating savings, Lincoln said.
"Along this line, R-SCAN allows for collaboration between referring healthcare providers -- physicians, nurse practitioners, or physician assistants -- with radiologists in choosing the best imaging possible, even if that means no imaging," Lincoln told AuntMinnie.com.
