Imaging has been all over the news lately—but the articles aren’t all about the technological wonders of modern radiology. Imaging is a service line that generates profits without which most healthcare organizations would suffer. The technology has improved dramatically in the past 15 or so years. But lately public attention has been focused on so-called combination scans—and some are wondering whether healthcare organizations are rightly reaping those profits.
A study in the this month’s issue of Radiology found that from 1995 to 2007 the number of emergency department visits that included a computed tomography (CT) exam increased from 2.7 million to 16.2 million, an increase of 16% per year. In and of itself the study, led by David B. Larson, MD, from the Cincinnati Children’s Hospital Medical Center in Ohio, isn’t exactly scandalous. One simple explanation is that there are more uses for the technologies today, researchers noted.
And research by heart imaging specialists at Johns Hopkins found that a combination of CT scans to detect coronary artery disease and its severity,
by measuring how much blood is flowing through the heart and the amount of plaque in surrounding arteries, are just as good as tests that are less safe, more complex, and more time-consuming.
“The newer, state-of-the-art CT scans are just as good as established older technologies in diagnosing the presence and severity of coronary artery disease,” said cardiologist and lead study investigator Richard George, MD. “In addition, the newer CT scans have the added advantages of being easier on the patient, taking less time to perform, using less radiation, and providing physicians with all the information they need in one test.”
But the public might not see it that way. An enterprising reporter in Connecticut used CMS’ Hospital Compare data to ferret out the fact that patients at the University of Connecticut’s John Dempsey Hospital are getting combination CT scans of the chest 48% of the time—nearly 10 times the national average. And more than 72% percent of patients who were sent for CT scans of the abdomen received double scans—also much higher than the national average of 19%.
“The data collected by CMS’ ‘Hospital Compare’ system shows that Dempsey, part of the UConn Health Center, has the highest rate of double chest and abdomen scans among all hospitals in the state, most of which are in line or have lower rates than national averages,” wrote Lisa Chedekel for the Connecticut Health Investigative Team website.
For its part, the hospital did conduct an internal review last year that flagged a high incidence of the multiple scans. It is taking a number of steps to address what radiology chair Douglas Fellows, MD, concedes is a “staggering” number of combination scans.
Clinicians with expertise in abdominal and chest imaging are working with physicians to encourage single scans, for example. And in cases where outpatients come to Dempsey with orders for double scans, Fellows’ staff is contacting doctors to push for single scans, according to the article.
Soon after Chedekel’s article was published, The Association of Healthcare Journalists, a professional organization for healthcare reporters, picked up the story. No doubt reporters will be checking CT scan rates at their own local hospitals, too.
It might be a good time to assess the number of combination scans at your own facility—and at the very least be prepared to talk to the press about the benefits of modern imaging.
For more recent news about imaging, read CDS Reduces Rate of Imaging Test Orders by 25% in Study and Medical Imaging Study Flags Portable Media Problems.