Ensuring the Right Medical
Imaging Procedure

When you are sick or hurt, you want the best tools to help determine what is wrong with you. Tests such as MRIs and CT scans are high-tech diagnostic imaging (HTDI) procedures. Over the last decade, their use increased about 10 percent a year, yet there is no proof that this increased usage improves patient care.

Using HTDI tests if they are not needed raises concerns. The use of CT scans, especially for children, is estimated to cause 1-2 percent of cancers in the U.S.¹ Most recently, the New York Times similarly reported the dangers of over-exposure from CT scans. Also, rapid growth in HTDI tests is the second largest contributor to rising health care costs.

Working with doctors, radiologists, health plans, patients and the Minnesota Department of Human Services, ICSI developed a patient-centered way to ensure the right HTDI tests are ordered. It relies on making “decision-support” criteria from the American College of Radiology (ACR) available through the doctor’s computer. The doctor can insert the patient’s condition and what they believe is the right imaging test, and the software tells the doctor if the selected test is of high, medium or low value for diagnosis. .

This electronic decision support helps clinics improve the health of patients, their care experience, and the cost of their care. More than 6,000 Minnesota doctors have been using decision-support for six years. It is estimated that usage has prevented 100 Minnesotans from getting cancer. Patients report they like this approach as they and their doctor can decide together what is the right test. The approach also turned an annual 8 percent increase in HTDI tests in Minnesota from 2003-2006, to a 1 percent total increase from 2007-2012. This saved an estimated $234 million, helping to keep health care costs lower.

1 Brenner DJ, Hall EJ. Computed Tomography—An Increasing Source of Radiation Exposure. N Engl J Med, Nov. 29, 2007; (22):357:2277-2284.