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ICSI's Work is Basis for CMS Move to Decision Support

ICSI’s HTDI Work Is Basis For CMS Move to Decision Support

A federal bill, which was based in part on ICSI’s work on high-tech diagnostic imaging (HTDI), has been passed that mandates that the Centers for Medicare and Medicaid Services (CMS) move to an electronic, clinical decision support (CDS) model for ordering advanced diagnostic imaging studies. This will require referring and ordering providers to use CDS tools based on physician-developed appropriateness guidelines for ordering diagnostic tests, effective January 1, 2017.

The bill, Protecting Access to Medicare Act--Section 218(b): Promoting Evidence Based Care, is a modified version of one submitted by Rep. Erik Paulsen (R-MN) and Jim Matheson (D-UT). Representative Paulsen visited ICSI headquarters in January to thank representatives from medical groups, health plans, radiology organizations and patient groups that designed and supported the ICSI initiative. The Minneapolis Star Tribune reported on the impact of the HTDI initiative and the Congressman’s visit in this January 7, 2014 article.

Impact on Diagnostic Imaging

Cindy Moran, assistant executive director of the American College of Radiology (ACR), told Diagnostic Imaging Magazine that the bill could have a significant, positive impact on how diagnostic imaging services are used in health care environments.

“Using CDS tools embedded with physician-developed appropriateness criteria will ultimately improve the accurate ordering of advanced diagnostic studies and ensure the appropriate studies are done for the right reason on the right patient,” she said. “We think this is absolutely the poster child of where policymakers want to go across the board for all issues of care.

“The physician sitting with the patient and trying to determine the appropriate imaging study for their diagnosis wants these tools,” she said. “Everything we’ve heard from their associations, they don’t like the mandatory pre-authorization or radiology benefit management firms. That’s a uniform consensus.”

It’s possible – and likely – Moran said, that state governments will see this federal legislation as a roadmap for effectively using CDS tools. The ACR’s hope, she added, is that they respond positively and embrace this trend.

April 28, 2014