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Statewide Initiative Launched to Help Ensure Patients Receive Appropriate High-Tech Diagnostic Imaging Exams
Date:11/10/2010

sts, health plans and DHS to explore options to prior notification processes for ordering high-tech exams. Put in place by several Minnesota health plans in 2007, prior notification helps ensure that appropriate HTDI exams are ordered. Most prior notification processes require the physician to call a radiology benefits management (RBM) firm to determine if an HTDI procedure is appropriate and covered by insurance prior to ordering it.

The ICSI pilot showed that using decision-support appropriateness criteria—based on American College of Radiology (ACR) and other specialty organizations' data—improved the diagnostic value of exams ordered, reduced patient exposure to unnecessary radiation, and contributed to a 0 percent increase in HTDI exams ordered in 2007 following an 8 percent increase in Minnesota in 2006. This resulted in an estimated $28 million in health care cost savings.

The five medical groups have continued to use the decision-support criteria since the pilot ended without having to call RBMs for prior notification approvals—these continue to be secured by using the appropriateness criteria in their EMRs.  The groups also report improved patient satisfaction, greater clinic efficiencies and reduced administrative costs. In total, it is estimated that by using this approach for the past three years, the five medical groups have helped save Minnesota $84 million, as there has not been an increase in the use of HTDI scans in Minnesota since 2007.

Based on more than 1 million scans ordered by the pilot medical groups, ICSI is offering this decision-support approach to all medical groups and hospital-based clinics in the state.  Medical groups with Epic EMR systems will have the earliest opportunity to adopt this solution, with the Web-based option available late in the first quarter of 2011.  

Decision-Support Tool

With this ICSI initiative, this proven approach is now being offere
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SOURCE Institute for Clinical Systems Improvement
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