Imaging Decision Support System Reduces Utilization, But Draws Crowds

MedCurrent drew crowds at RSNA 2011 with OrderRight, its decision support tool. The OrderRight “widget” integrates into EHRs, guides ordering physicians through a series of questions about their patient, and suggests the correct test, based on criteria from the American College of Radiology (ACR). No more trying to keep the latest suggestions straight in your head; patient-specific protocols appear on screen.

Such decision support reduces volume for radiologists, MedCurrent’s Beth Frost-Johnson baldly stated. In fact, a study in the January 2011 Journal of the American College of Radiology, showed that decision support was associated with a 23 percent to 27 percent drop in utilization of sinus CT and MRIs of the head and lumbar spine. But the cut in volume results from good decisions based on clinical evidence, decisions most physicians can live with.

“This is not an electronic RBM [radiology benefit management] tool,” Frost-Johnson stressed. “We don’t tell physicians what to do; we offer recommendations. … And we also tell them why, and that’s something the RBMs don’t do. … You cut the right fat.”

New reimbursement models focus on cutting costs without hurting quality, she adds. If radiologists are getting paid for better care or sharing in cost cuts, this is the sort of system they’ll need. The activity at the MedCurrent booth suggests a heightened attention to the newer models.

Crowds check out decision support tool at RSNA 2011

Besides, few referring physician want to struggle through a painful RBM pre-authorization or denial; if they know they are following guidelines, they feel more comfortable they are not only doing the right thing, but will eventually get paid. Because the product integrates with EHRs, even extracting basic patient data from referring physicians’ records, it doesn’t require them to interrupt their workflow, improving adoption. Decision support isn’t a new idea, but it previously required physicians to launch an entirely new system, interrupting their work.