Facility Management

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The new ACO model could dramatically affect how radiologists practice, and now’s the time to get involved in the process. Dr. Steven Gerst, MD, MBA, MPH, CHE, vice president of medical affairs at technology company MedCurrent, sheds some light on ACOs and what radiologists should be doing now to prepare.

The FDA this week outlined a plan to improve the path to market for medical devices, including streamlining the review for low-risk devices and clarifying when clinical data should be submitted. The agency is deferring some of the contentious decisions, giving the Institute of Medicine a chance to provide feedback on seven recommendations.

CMS has plans to implement changes to Medicare’s Provider Enrollment, Chain and Ownership Systems (PECOS), which is used to enroll physicians into Medicare. Under the impending changes, CMS will deny claims for services ordered or referred by a physician who doesn’t have a PECOS file. That, of course, means no payment.

It’s a question practices should be asking in the wake of the news that a server containing personal patient and billing information was breached at a radiology practice in Rochester, N.H. It’s the latest security breach made public under the HITECH Act’s security breach notification rules.

Transvaginal ultrasound demonstrates good sensitivity and specificity for detecting endometrial cancer, a study from the University College, London. finds. But that doesn’t mean it’s suited for use in the general population just yet. The researchers found transvaginal ultrasound is better for high-risk groups prone to endometrial cancer, and especially in the management of postmenopausal women undergoing pelvic scans for reasons other than vaginal bleeding.

A significant decision regarding these standards looms over us now - how to incentivize or discourage certain behavior. There is not a right or wrong answer to this. The group needs to decide when and how hard the rubber meets the road. In our minds, our options include publication of statistics either anonymously or openly, hoping for behavior modification; escalation of punishment for failure to meet a standard, by financial or other penalties; or incentives for those performing best.

Laura and her husband Paul landed in Boston to begin a whirlwind tour of several major East Coast cities in celebration of their second wedding anniversary. As a Brit, Laura most looked forward to touring the sites of the city that helped ignite the American Revolution. Following a bowl of “chowda” and a few pictures along the Charles River, they would bid farewell to Beantown and headed toward the bright lights of the Big Apple.

Dose reduction at one time played second fiddle to image quality, but today it enjoys top billing. New algorithms are coming into play in CT, radiography, and fluoroscopy to maintain image quality at traditional levels by processing out the noise that sneaks in during low-dose exams. In some cases, fear of radiation has gotten so bad that patients forego CT and other sources of ionizing radiation all together.

Historically, radiologists have been leaders in the adoption of new technologies. The first radiology computer-assisted coding (CAC) product went into commercial production in early 2000. Since that time, hundreds of millions of radiology reports have been coded and audited using CAC.

Linda could not shake the pesky cough and congestion that had settled into her chest. She knew a quick trip to the doctor was the most prudent course of action but couldn't afford it. When she finally had to go to the emergency room, she received three imaging examinations in succession for a common ailment that could easily have been diagnosed by a physical exam and laboratory tests alone.

Our business has changed substantially in recent years. Ours was a practice that was primarily hospital-based. However, it underwent a paradigm shift, and the group has added a substantial amount of teleradiology and non-hospital based business. In so doing we have made several philosophical decisions and must continue to consider those.

CT scout or scanogram images make up only about 4% of the typical chest/abdominal scan radiation dose, but are an easy target for dose reductions, according to a study presented Wednesday. Further, as technology changes and protocol updates reduce overall dose rates, scout images will make up a relatively larger part of the total and still represent a good target for cuts.

A Monday morning scientific session covering cardiac CT dose and noise broke down into newsworthy matched pairs: two studies examining the implication of CT radiation on public health, two investigating the impact of radiation reduction strategies on patient dose and image quality, and a third pair considering how noise reduction from iterative reconstruction affects the quality of images of highly calcified vessels and morbidly obese patients.