Evolving Board Certification: What the ACR is Doing

Eric Friedberg_ACR17-116rThis post was contributed by Eric Friedberg MD FACR, chair of the American College of Radiology Certification in Radiology Task Force.

Controversies surrounding Maintenance of Certification (MOC®) are increasingly dynamic and of considerable interest to American College of Radiology (ACR) members.

As Chair of the newly created ACR Certification in Radiology Task Force, I want to update you on what the ACR is planning, studying and doing to address this important issue.

In response to a recent request from the American Board of Medical Specialties (ABMS), the ACR created a work group to comment on a report on the status of MOC® across all specialties. That group worked tirelessly over the winter holidays to prepare a detailed comment letter.

The ACR also signed on to a letter from the Council of Medical Subspecialty Societies (CMSS), which represents approximately 800,000 physicians from 43 medical subspecialty societies.

Both the ACR and CMSS letters call for an immediate moratorium on MOC® until many programmatic deficiencies are corrected.

At the combined Board of Chancellors (BOC) and Council Steering Committee (CSC) meeting in January, the Certification in Radiology Task Force was created as a partnership between the BOC and CSC. This task force also includes several at-large ACR members.

The Task Force is propelled by recognition that ongoing certification is an area of increasing physician and ACR member interest and concern. An ABMS survey of approximately 35,000 physicians revealed that only 12 percent of the physicians value the current MOC® programs.

The ACR is aware of these concerns, stating in its ABSM response letter that, “[t]he ABMS Vision Initiative report both underestimates and understates the reality, robustness, and energy of a growing grass roots ‘anti-board movement.’”

These important ACR member issues have recently been amplified by the backdrop of various ABMS member boards coming under intense scrutiny and even legal actions for financial practices, lack of transparency, non-democratically elected leadership, high-stakes non-validated psychometric testing and concerns about monopolistic behavior. The American Board of Radiology (ABR) was named as a defendant in one class action suit and a “co-conspirator” in another.

Our Task Force is studying these issues and preparing to make recommendations to the BOC and CSC at both the ACR 2019 and ACR 2020 annual meetings.

The ACR online member forum, ENGAGE, has become a hub for communication on related issues. We encourage you to participate in those discussions.

Your opinions matter. We are listening, and are committed to acting on your behalf.

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

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ACR 2019 Attendees to Get a Taste of AI

Am. College of Radiology-AMCLC

Dr. Allen

This post was contributed by ACR Data Science Institute Chief Medical Officer Bibb Allen, MD, FACR, and Chief Science Officer Keith Dreyer, DO, PhD, FACR.

 The American College of Radiology (ACR) Data Science Institute (DSI) is developing a framework for radiologists in all practice settings to use artificial intelligence (AI) tools to help improve performance and efficiency.

As a first step toward allowing local radiologists to take part in AI development, the ACR DSI will allow attendees at the May ACR 2019 annual meeting to use ACR DSI data and cloud-based computing to gain experience annotating cases and see how AI algorithms can improve with additional training.

  • Attendees can assess breast density using ACR cases and annotated cases which will then be used to train an algorithm to perform the same function. The more members who take part in contributing cases, the more accurate the algorithm will become.

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    Dr. Dreyer

  • In order to specifically target trainees, over the summer, radiology residents will be invited to participate in a 60-day “Resident Breast Density Challenge” where they will use ACR DSI-hosted data and computing to train and develop an ACR DSI Breast Density Algorithm.

The ACR DSI is enabling radiologists to shape the future of radiology technology and patient care.

We hope that you will take advantage of the opportunities this process will bring in 2019. 

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

 

CT Colonography: A Cancer Screening We Can All Get Behind

kjchang_photo_This post was contributed by Kevin J. Chang, MD, FSAR, Director of CT and IT at Newton-Wellesley Hospital in Newton, Massachusetts and a member of the American College of Radiology (ACR) Colon Cancer Committee

Each year in March, for Colorectal Cancer Awareness Month, we pause to consider that more than 145,000 Americans are diagnosed with colorectal cancer each year, and over 50,000 die because of late detection. This is all the more tragic when you consider that colorectal cancer is largely preventable—and has a 90 percent cure rate when detected early through recommended screenings.

In 2018, the American Cancer Society published their updated guidelines for colorectal cancer screening, which concluded that adults aged 45 years and older with an average risk should undergo regular colorectal cancer screening every five years. The United States Preventative Task Force (USPSTF) has given colorectal cancer screening an “A” rating. CT Colonography (CTC), often known as “virtual colonoscopy,” is one of the available screening options.

There is widespread agreement among the medical community that the best colorectal screening test is the one that gets done. Virtual colonoscopy does not require sedation. It is over in minutes. You can go back to daily activities and you don’t need anyone to drive you home. These and other unique features of CTC make it an appealing test for many Americans.

The Patient Protection and Affordable Care Act requires private health insurers to provide, without patient cost-sharing, all preventive services that earn grades of A or B in USPSTF recommendations – so CTC is covered by insurers. That’s good news for many.

However, the Centers for Medicare and Medicaid Services has yet to grant reimbursement for Medicare beneficiaries who choose CTC for screening in lieu of conventional screening colonography despite the USPSTF’s previous positive recommendation. That leaves millions of Americans unable to choose CTC, a test that could save their lives. Many of these may forego any colorectal cancer screening at all.

The ACR’s Colon Cancer Committee, along with government relations staff, have been working to pass legislation that would mandate Medicare coverage of CTC. Last year’s bill had 86 co-sponsors, and we anticipate this session’s version of the legislation to be introduced in the next few days.

The ACR also recently submitted a comment letter to the USPSTF regarding the task force’s draft research plan for an upcoming five-year review of its recommendations for colorectal cancer screening.

The bottom line: CTC is life-saving, safe, cost-effective and could reduce the racial and ethnic disparities that plague colorectal cancer screening adoption.

For more information, please consult the ACR’s Colon Cancer Screening Resources and encourage your patients to learn more at RadiologyInfo.org.

  • How are you working to educate patients, primary care physicians and lawmakers about CTC?
  • Join the conversation all month long on social media using hashtags #VirtualCT, #CTColonography and #CRCAwareness, and by following @RadiologyACR on Twitter.

Please share your thoughts in the comments section below and join the discussion on Engage (login required).