Radiology is Invaluable to Value-Based Care

Pamela T JohnsonThis post was contributed by Pamela T. Johnson, MD, Radiology Vice Chair Quality, Safety & Value and Physician Lead, Value-based Care at Johns Hopkins Hospital.

As the cost of health care in the United States continues to rise, so do our patients’ concerns about those costs. In fact, many American families now cite the cost of health care as their biggest financial concern, and as many as 1/3 of U.S. adults have gone without recommended care, did not see a doctor when sick or failed to fill a prescription due to cost.

That’s why I value my work as a director of the High Value Practice Academic Alliance (HVPAA) so strongly. HVPAA is a national alliance of faculty leaders from 90 partner institutions, representing 30 different medical specialties & subspecialties,  working to deliver large-scale improvements in health care value through collaborative quality improvement, education and research. The rapid growth of the organization, its national conference, contributions to the literature and approval as a CMS Provider Led Entity (QPLE) are testament that radiology is uniquely qualified to lead care redesign.

Why? Because all specialties connect to radiology, we are knowledgeable about other disciplines in medicine and we are consistently among the first specialties to embrace the critical importance of educating ourselves and other physicians regarding change and innovation.

I was honored to lead the team that won the Teaching Value Innovator Award in the 2018 Cost of Care Value Challenge for “Order Wisely: A new cross-specialty paradigm for imaging appropriateness continuing medical education.” The project involved designing a full-day continuing medical education (CME) program that reviews appropriate use of imaging exams, lab tests, medications, transfusions and other treatments. Half of the program is dedicated to appropriate use of imaging exams, since evidence shows that education about the ACR Appropriateness Criteria reduces costs by helping providers select only the most appropriate imaging, and to prepare our non-radiology colleagues for the CMS Appropriate Use Program.

I also applaud the work of Mike Cheng, MD, a principal investigator for Radiology-TEACHES, and his colleagues at the University of Chicago who were finalists in the Cost of Care Value Challenge and placed third in the category of “High Value Care Educational Curricula” for their work on Imaging Wisely: An Introduction to the ACR Appropriateness Criteria and Analysis of its Impact on Internal Medicine Residents. This project involved integrating a curriculum into the required ambulatory lecture series for internal medicine interns at the University of Chicago to introduce them to the ACR Appropriateness Criteria and teach them to apply it to case vignettes through the Radiology-TEACHES online portal.

In another recent collaboration, the HVPAA radiology team will be working with the Radiology Support, Communication and Alignment Network (R-SCANTM) team to expand the R-SCAN program’s focus areas to include all the CMS Priority Clinical Areas as described in Protecting Access to Medicare Act (PAMA). This effort is will help to ensure that radiologists and referring clinicians are working together and prepared well before the requirements take effect in 2020. The HVPAA Radiology Collaborative is co-directed by ACR member Yoshimi Anzai, MD, MPH, Associate Chief Medical Quality Officer at University of Utah, and consists of 30 radiology departments working together to improve appropriate use, standardize imaging report recommendations in accordance with the ACR White Papers and ACR Appropriateness Criteria, and develop value measures for radiology.

These initiatives and others are all creating quality educational opportunities and materials to include: the ACR Value-based Imaging Activities, the lecture videos from the Order Wisely conference, a free 4-year online high value care curriculum for medical schools and graduate medical education training programs, as well as a myriad of other resources available on the HPVAA website.

I encourage you to share these resources with other physicians and medical providers you work with in all medical specialties. Through education and collaboration, we can increase quality and affordability while easing patients’ concerns and achieve our mission of radiology-led, quality-driven care redesign.

  • How are you advancing value-based care in your radiology practice?
  • Have you signed up for the “PAMA AUC Deadline is Firm—Prepare Now for 2020!” webinar on Dec. 11 at 7pm EST? If you haven’t, register today.

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