New imaging best practices are being implemented systemwide in the coming weeks to improve care and help us stay compliant with Centers for Medicare and Medicaid Services requirements in the Protecting Access to Medicare Act of 2014 (PAMA).
"This program will require providers to document consultation with appropriate use criteria implemented through clinical decision support software whenever they order certain advanced imaging studies," says Keith White, MD, senior medical director of Imaging Services. "The goal is to assure patients gets the correct imaging procedures that will provide the most relevant information for physicians. The process will also allow the Radiology Department to make sure the exam is appropriately protocoled, and the report tailored to the specific questions providers have about the patient."
Intermountain has built customized software within iCentra that will allow caregivers to directly deploy the criteria in a way that's been tested and validated to be as seamless as possible. It's been designed, built, and tested by Intermountain physicians.
Kieth White, MD
The collection of care process models developed by the clinical programs for this project have been named "Proven Imaging." "These best practices will benefit providers by preventing penalties from CMS," Dr. White says. "As they provide evidence-based care, it will protect them from being singled out and identified as outlier physicians. CMS will at a future date require outlier physicians to use a preauthorized program before ordering advanced imaging procedures."
Providers will soon be able to order the evidence-based tests in iCentra. Because CMS requirements extend to all orders for all applicable imaging for outpatient and emergency department patients, a third-party company will help build the Proven Imaging care process models into software that will be provided free to affiliate practices to assist them when they order outside iCentra. Imaging leaders will work closely with affiliate providers to make sure the integration goes as smoothly as possible. The deployment to affiliate offices will be happening throughout 2020.
This program applies to the ordering of CT, MR, nuclear medicine, or PET exams for any of the following: Chest pain, hip pain, shoulder pain, neck pain, lower back pain, suspected pulmonary embolus, lung cancer, and headaches.
Caregivers will see the new care process models become available in iCentra and for physician groups now through early 2020.