November

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Imaging Decision Support Scoring Upgrade

Published on Tuesday, November 27, 2018

On Monday, December 3, the indications on imaging orders will be updated automatically as part of the scheduled upgrade of the decision support tool (ACR Select) to the newest version, CareSelect. The two primary changes for providers include a new Acknowledgement Reason on the BPA alert, and new indications on imaging orders:

  1. Acknowledgment reason for low and marginal scores:
    • Providers can select an acknowledgment reason in the BPA when proceeding with marginal exams scoring 4-6.
    • Providers are required to choose an acknowledgment reason when ordering inappropriate exams scoring 3 or less.

      Image: BPA Alert, Acknowledgment Reason

  2. Multiple content sets
    Indications now include content from the American College of Radiology and four additional clinical sources. This should enhance the content available when selecting an indication for an imaging study.
    • American College of Radiology (ACR), including Society of Pediatric Radiology (SPR)
      • Evidence-based decision support for the appropriate utilization of all medical imaging procedures. More than 300 volunteer physicians, representing over 20 radiology and non-radiology specialty organizations, participate on expert panels to continuously update these guidelines.
      • SPR Imaging criteria has been developed by leading pediatric experts through the American College of Radiology's Rapid Response Committee process with the support of the Society for Pediatric Radiology.
    • American College of Cardiology (ACC)
      • Provides widespread coverage of cardiac advanced imaging procedures.
      • Criteria is authored by the ACC Appropriate Use Criteria Task Force who oversee the creation of topic-specific indications. Topics are selected by the AUC Task Force after careful review of the current variation in utilization, stakeholder needs, procedure volume and cost, available evidence, and feasibility.
      • The AUC are aimed at guiding both diagnostic and therapeutic procedures based upon specific, commonly-encountered clinical scenarios. ACC and AUC are both evidence-based and utilize expert consensus.
    • National Comprehensive Cancer Network (NCCN)
      • Includes recommendations pertaining to cancer screening, diagnostics, staging, treatment response assessment, follow-up, and surveillance. Also document information on disease stage and histology.
      • NCCN develops imaging appropriate use criteria based upon each multidisciplinary Guidelines Panel's evaluation of available scientific evidence, including published literature and the expert judgment of the panel members.
    • Society of Nuclear Medicine and Molecular Imaging (SNMMI)
      • SNMMI follows a balanced multipdisciplinary approach to guidance development. The SNMMI Guidance Oversight Committee has identified several high-priority areas for AUC development ranging from Bone Scintigraphy for Prostate and Breast Cancer to Thyroid Imaging.