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Radiology’s role in quality metrics and value-based care

by Sean Ruck, Contributing Editor | May 11, 2018
Health IT
Greg Nicola
From the May 2018 issue of HealthCare Business News magazine

HealthCare Business News recently spoke with Dr. Gregory N. Nicola FACR, executive leadership, Hackensack Radiology Group, and ACR MACRA chair about quality metrics and value-based care, and how radiology plays a part.

According to Nicola, radiology’s quality metrics are moving toward diagnostic accuracy measures. “In other words, did our interpretation match the downstream pathology or surgical findings?” he explained.
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One of the barriers for radiology-specific measures is that they are unfamiliar to many other providers outside of the specialty including clinicians and hospitals, but also payors. “Comparing us to a gold standard like pathology is exactly where we think one focus of quality measurement should be. However, we have had payors state our proposed diagnostic accuracy measurements are really disease prevalence measurements, and therefore difficult to compare across disparate populations” he said.

“So there’s a disconnect in accepting some of our measures, but I think we have a lot to offer in other quality measure development areas, not only in the diagnostic accuracy, but also in efficiency type measures. What I mean by that is ‘are the radiologist’s recommendations incorporating cost-effective, appropriate, standardized recommendations that decrease variability of downstream medical events including repeat imaging?’”

Nicola plays an active role with the ACR and sits on a technical expert panel for quality measurement development in radiology, so his questions hold weight. His input also plays a part in helping societies develop measures to standardize follow-up recommendations in radiology, helping to reduce variability and decrease cost. “I think that’s really worth looking into,” he said. “We can add a lot of value to the health care system, particularly by decreasing variability of follow-up imaging.”

While the development of quality metrics is moving along, there are other challenges tied to value-based care. For example, radiologists still have to contend with redundant imaging procedures. “It’s probably the greatest barrier for radiologists in attempting to play an active role in being cost effective,” Nicola acknowledged. “Those of us trying to practice value-based care have little access to what the patient had done in the past if they were at a disparate institution.”

Nicola feels that the challenge shouldn’t even exist, “It’s ridiculous, because technologically, it’s seamless to share images. It just doesn’t happen in the practical sense.”

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