On an annual basis, as the Center for Medicare and Medicaid Services (CMS) designates Priority Clinical Areas (PCAs), the medical director of Imaging Services collaborates with the medical directors of the Clinical Programs to determine which Clinical Program is most appropriate to lead out in developing and managing Care Process Models (CPMs) relevant to the PCAs. The appropriate scope of the project is established.
At a minimum, the scope will include the development of appropriate use criteria sufficient to encompass the breadth of advanced imaging use (MR, CT, NM, PET) for the entire PCA. Scope may be extended to include upstream and downstream content.
Upstream content would include requirements and processes for acquiring needed history, physical exam, laboratory or other diagnostic studies, etc. used to guide the clinician to the appropriate ordering of an advanced imaging procedure (Diagnostic CPM). Downstream content would include determinations as to how the imaging study results would impact further diagnostic or therapeutic interventions (Comprehensive CPM).
In collaboration with operational leaders, a project plan is developed, where the proposed scope of the project is discussed and defined. Anticipated resource requirements are estimated. Project plans include a determination of what AUC architecture(s) are to be used. The project plan is approved by Clinical Program and Imaging Service leadership.
Priority Clinical Areas and Their Clinical Programs
Below is a table of the CMS-designated PCAs, along with the Intermountain Clinical Program that is the most relevant to each PCA.
|Priority Clinical Area (PCA)
|Chest Pain (includes angina and suspected myocardial infarction)
|Suspected Pulmonary Embolism
|Headache (traumatic and non-traumatic)
|Low Back Pain
|Lung Cancer (primary or metastatic, suspected or diagnosed)
|Shoulder Pain (to include suspected rotator cuff injury)
|Cervical or Neck Pain