Healthcare Leaders Promote HIT enabled Decision Support Tools to Assure Medically Appropriate Imaging Tests for All Patients: The Right Test, at The Right Time

An alliance of leading healthcare providers, technology companies and diagnostic imaging organizations have joined forces to form the Imaging e-Ordering Coalition (The Coalition). This national initiative will promote Health Information Technology (HIT) enabled decision-support (e-Ordering) as a solution to assure that all patients receive the most medically appropriate diagnostic imaging test for their specific condition. Members of the Coalition are devoting their energies to help educate policy makers and healthcare providers about the patient-centered efficiencies of e-Ordering, as well as recommending to lawmakers that the efforts to build incentives for prescribing medications electronically (e-Prescribing) should be broadened to include diagnostic imaging e-Ordering solutions.

“As the healthcare industry, federal government and various regulatory bodies evaluate strategies to contain the rising cost of healthcare, e-Ordering is increasingly recognized as a cost-effective and data-driven approach to assure clinical best practices are applied to all ordering decisions,” said Bibb Allen, M.D., of the American College of Radiology, and founding member of the Imaging e-Ordering Coalition. “Expanding on the e-Prescribing model, e-Ordering will do for diagnostic imaging what e-Prescribing has done for the drug prescription process - simplify the way physicians’ decisions for patient care are verified as medically appropriate and safe without compromising the physician-patient relationship.”

There are a variety of active legislative and regulatory proposals that attempt to address the utilization of imaging services for publicly subsidized programs such as Medicare and Medicaid. The Coalition is focused on the following components and has achieved measured progress within each:

• Promote existing HIT legislative concepts to inform policy makers on the value of e-Ordering to enable the appropriate use of imaging.
• Ask lawmakers to include e-Ordering in the development of healthcare system efficiency incentives.
• Act as a resource for the Centers for Medicare and Medicaid Services (CMS) on its Medicare Imaging Demonstration Project established by Congress in Section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
• Work with policy makers to have the Coalition’s e-Ordering proposal for CMS scored to validate long-term value and savings for the healthcare industry.
• Work with stakeholders to establish standards to accelerate e-Ordering as a meaningful and valuable application with EHRs.

According to the Coalition, e-Ordering prevents many of the potential issues associated with radiology benefit managers (RBMs), which are organizations employed by some healthcare insurers to manage utilization and costs associated with high-tech diagnostic exams. Concerns with the RBM model, include regulatory oversight and a manually burdensome “prior authorization” system whereby physicians must receive approval before ordering an imaging service.