Intermountain Healthcare, through its Intermountain Imaging Criteria initiative is dedicated to the development, maintenance, and deployment of evidence-based standards for imaging in support of its mission of helping people live the healthiest lives possible. The appropriate use of imaging must be defined and understood within the specific clinical context in which it occurs. This context can be very complex and include factors such as demographics, prior medical history, signs and symptoms, prior diagnostic test results and current therapies.
Further, a full understanding of context includes the anticipated downstream impacts of the imaging service result on therapy and ultimately on outcome. The Intermountain Imaging Criteria guidelines are framed within a population health management model where evidence-based preventative, diagnostic, therapeutic, and palliative standardized care processes are interwoven to form evidence-based care pathways across the continuum of care.
Intermountain Imaging Criteria Leverages Clinical Programs and Care Process Models
Multidisciplinary clinical teams called Clinical Programs are organized within Intermountain to develop and oversee implementation of evidence-based standards of care for defined sub-populations. Current Intermountain Clinical Programs include the following:
- Behavioral Health
- Intensive Medicine
- Primary Care
- Surgical Services
- Women and Newborn
Experts in imaging including radiologists and cardiologists serve within the Clinical Programs as domain knowledge experts in imaging. The main work of the clinical programs is to develop Care Process Models (CPMs) for the key processes of care provided within their clinical domain. Imaging services are component services within the CPMs. This architecture allows for very complex clinical context to be specified for the imaging service and very importantly links the outcome of the imaging service to other downstream diagnostic and/or therapeutic services.
In addition to providing guidelines for care, CPMs also include the collection and analysis of data metrics that allow objective assessment of CPM impacts on outcome and on the total cost of care. CPMs functionally serve as a portfolio of dynamic Quality Improvement initiatives that are the essence of a Learning Healthcare System.
Creation of Imaging Appropriate Use Criteria
The Intermountain Imaging Criteria initiative leverages the Clinical Program infrastructure to develop Imaging Appropriate Use Criteria (AUC), generally in a CPM architecture. The steps to AUC development include:
- Identification of Priority Clinical Areas as defined by CMS, and assignment to the most appropriate Clinical Program and development of a project plan.
- Constitution of a development team to build and maintain the AUC.
- Performance of an evidentiary review.
- Creation of AUC in the most appropriate format.
- Testing and validation.
- Publishing AUC to Intermountain’s Intermountain Imaging Criteria website.
- Review on an annual basis of published AUC.
Details of how each step will be carried out can be found by using the directory below or the "Intermountain Healthcare: Intermountain Imaging Criteria Process" PDF link above.