An alliance of health care providers, technology companies and imaging organizations plans to cut waste in spending for unnecessary or duplicative imaging testing by proposing an electronic ordering system. The e-Ordering solution, which has been presented to the federal government, would be used in lieu of the familiar radiology benefits management systems (RBMs) allowing for improved workflow and resulting in better patient care.

Coalition Co-founder Scott Cowsill explains, "The Imaging e-Ordering Coalition (Coalition) started as a grass-roots organization in Minnesota in response to the GAO's report to the federal government citing the need to save money on imaging testing especially for Medicare/Medicaid. In keeping with the Institute for Clinical Systems Improvement guidelines, which supports the use of evidence-based medicine, we implemented a statewide imaging system based on a progressive electronic data system (EDS) model."

Talking with Capitol Hill
From its roots, the alliance grew to a national initiative. The Coalition engaged legal authority and lobbying firm Holland & Knight to take the Imaging e-Ordering system before legislators in Washington. The goal was to educate the policymakers on alternative options to RBMs for utilization management.

"Feedback from policymakers indicates support. We're told that our system is exactly what they had talked about and hoped for but didn't know existed. Plus, it is deployable on a large scale," Cowsill tells DOTmed News. "We've been able to protect e-Ordering as an alternative within the legislative language, and we continue to educate the federal policymakers," he adds.

To date, there are six members of the Coalition: American College of Radiology (founding member), Center for Diagnostic Imaging, GE Healthcare, Merge Healthcare, Medicalis and Nuance Communications.

"As the health care industry, federal government and various regulatory bodies evaluate strategies to contain the rising cost of health care, e-Ordering is increasingly recognized as a cost-effective and data-driven approach to assure clinical best practices are applied to all ordering decisions," says Bibb Allen, MD, American College of Radiology.

"The growing emphasis at all levels of the federal government to encourage adoption of health information technology presents an opportunity for the Coalition to elevate e-Ordering as a much more provider-friendly, patient-centered alternative to the RBM model," says Liz Quam, Director, Center for Diagnostic Imaging Institute, and co-founding member of the Coalition.

"As a provider of diagnostic imaging services in nine states, my company has seen the inconsistencies in insurers' utilization efforts. None of those efforts are without hassle for the health care providers striving to offer patient-centered care," says Quam.

The Senate committee's vote on the legislation is scheduled for just after July 4th.

e-Ordering Benefits
In general, EDS permits interconnectivity and interoperability via a plug-and-play module. The ease of use improves workflow, allowing the physician to order appropriate diagnostic testing online decreasing time away from the patient. The EDS provides a data trail to validate with information on a patient's chart. The back end benefit houses a collection of data to learn from. Further, in addition to the test ordered, alternatives, and sometimes more medically appropriate tests, are suggested.

Cowsill gives an example of what he calls soft ROI, how EDS benefits the patient. "Without EDS, a referring physician would schedule a CT for a patient's knee, the patient would take a day off from work to have the test, perhaps a family member would have to drive the patient to the test site, the test would be done, and the results would show that instead of a CT, the test should have been an MRI. Now the new test has to be ordered, and the patient repeats the costly process. With e-Ordering, that should not happen."