Reducing Scans, Improving Care

Cheryl Clark, May 28, 2015

Decision-support tools and continual monitoring of imaging study use are helping healthcare leaders limit unnecessary exposure and waste.

This article first appeared in the May 2015 issue of HealthLeaders magazine.

At Massachusetts General Hospital in Boston, getting red rated is not something staff doctors would ever boast about. It means that MGH analytics has determined the physician tends to order too many high-end imaging studies—like MRIs, CTs, or PET scans—without clinical justification based on the patient's symptoms.

Rather than revealing information that would influence a treatment decision or prognosis, those unjustified images are more likely to result in potential harm through radiation exposure, or lead to more imaging tests, patient worry, allergic reactions, or invasive procedures. Of course, this all adds to costs, which could hurt hospital scores on Medicare's spending-per-beneficiary efficiency measure.

"The biggest potential harm is over-diagnosis and the possibility of subjecting patients to downstream testing and emotional anxiety based on tests they didn't need in the first place," says James Brink, MD, radiologist in chief at the 199-bed facility.

"Our system enables us to encourage appropriateness reviews for high-end imaging exams."

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