A Catalyst for Change

Raoof, SabihaSabiha Raoof, MD, FCCP, FACR, chief medical officer of MediSys Health Network and chair of radiology at Jamaica and Flushing Hospitals in Queens, NY who served as a TCPI National Faculty Member, contributed this post.

Recently, I had the opportunity to present the results of the American College of Radiology (ACR)’s Radiology Support, Communications and Alignment Network (R-SCAN) to other health care associations, physicians and leaders of the Centers for Medicare and Medicaid Services’ (CMS) Transforming Clinical Practice Initiative (TCPI) at the TCPI conference. This conference was a culmination of the four-year TCPI program.

I was fortunate to be selected as a National Faculty Member for TCPI in 2015 when the ACR recommended me to serve. Through this experience, I rediscovered the joy in caring for others and amplified my voice as a radiologist and subspecialist.

In addition to my role as chief medical officer of the MediSys Health Network, I  also serve as the chairperson of radiology at Jamaica and Flushing Hospitals Queens, NY. These private community hospitals provide safety net coverage to an incredibly diverse population and perform approximately 240,000 combined exams each year.

TCPI and R-SCAN provided us with a roadmap to transition our practice from volume-based to value-based imaging care. All 600 of our clinicians enrolled in the program, engaging in various educational sessions,  one-day seminars on performance improvement and a variety of performance improvement projects. Our physicians embraced the importance of learning more about the appropriateness of certain advanced imaging and leveraging clinical decision support (CDS) to make an educated decision about which imaging study would have the highest yield for an appropriate diagnosis. We began implementation on the inpatient side in both hospitals and moved toward the outpatient and ED settings. We also started a radiology consult service so if referring clinicians had any questions when ordering imaging, they could pick up the phone and call the radiologist. We were proud to be one of the first hospitals in the country to implement CDS and then to use the data from the CDS R-SCAN Registry to complete an R-SCAN quality improvement project that significantly improved the ordering of imaging for minor head trauma in the Jamaica emergency department. We graduated from TCPI in just one year, as opposed to the predicted four-year track; transformed into diagnostic centers of excellence; and changed the trajectory of value-based care at our facilities.

As we all prepare to fully implement the CDS requirements of the Protecting Access to Medicare Act (PAMA), beginning on January 1, 2020, we must be the voice of our specialty. Don’t just sit in the office – get involved in your communities and bring your voice to the table. We can and will be the catalysts of change for the good of our patients and the practice of medicine.

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