Minnesota’s Institute for Clinical Systems Improvement (ICSI), a group of sixty health care organizations and providers, has announced a new partnership designed to reduce unnecessary expenses for high-tech diagnostic imaging (HTDI) tests while protecting the doctor-patient relationship.
Massachusetts-based Nuance Communications will partner with ICSI to propel a first-of-its-kind effort to ensure all patients receive appropriate tests, such as MRI, CT, PET, and nuclear cardiology. Known as “RadPort,” Nuance’s evidence-based decision-support program presents a potential model for other states in solving a problem that has elicited outrage and concern from the medical establishment in recent years.
Analysis of Trends, Outcomes
A nonprofit bringing together more than 60 medical groups and six sponsoring health plans throughout Minnesota and surrounding states, ICSI expects its licensure of Nuance’s electronic e-Ordering system to save Minnesota providers more than $28 million per year. In addition to RadPort, ICSI will pair Nuance’s “RadCube” software solution to analyze physician-ordering trends in parallel with patients’ actual clinical outcomes, according to Cally Vinz, vice president of clinical products and strategic initiatives at ICSI.
“This initiative will yield many patient, provider, health plan, and community benefits and potentially serve as a national model for how to help reduce the more than $100 billion spent annually on high-tech diagnostic imaging tests across the U.S.,” said Vinz. “Nuance’s electronic decision-support and patient outcome analysis solution will guide appropriate ordering at the point of order, to ensure the best exam is ordered for the patient every time. We will also have better insight into physician ordering habits and their impact on patient care.”
Pilot Program Results Backed Decision
In a yearlong pilot program in 2009 which tracked more than 2,300 physicians from five Minnesota medical groups and five health plans using e-Ordering to order HTDI exams, results showed exams ordered with evidence-based, decision-support technology supported an increase in medical appropriateness. The same pilot showed utilization of decision-support appropriateness criteria in the physician’s offices reduced patient exposure to unnecessary radiation and helped the state have no increase in HTDI scans ordered in 2007 (following Minnesota’s 8 percent increase in 2006).
An estimated $28 million in healthcare cost savings was reported during the pilot.
Each of the medical groups that took part in the pilot program has continued to use the decision-support criteria since then, reporting improved patient satisfaction, greater clinic efficiencies, and an overall reduction in administrative costs of over $84 million, according to ICSI. There has not been an increase in the use of HTDI scans in the state since 2007.
Scott Cowsill, chairman of the Imaging e-Ordering Coalition—which includes the Alliance for Quality Imaging, the American College of Radiology, GE Healthcare, and Radnet, among others—calls the system a “national benchmark” which will be a “model of utilization management for high tech imaging and is the delivery pathway for the future.”
“This is a way for keeping clinical decisions within the physician-patient relationship. It’s a win-win for everyone,” said Cowsill.
Rina Shah ([email protected]) writes from Washington, DC.