Medicare Announces Demonstration Testing Decision Support Systems For Advanced Medical Imaging Services

Medicare Announces Demonstration Testing Decision Support Systems For Advanced Medical Imaging Services: "The Centers for Medicare & Medicaid Services (CMS) announced that it is soliciting proposals for participation in the Medicare Imaging Demonstration (MID)..."
Additional information about this demonstration including how to apply can be found here.
Questions on this demonstration may be submitted to CMS at: ImagingDemo135b@cms.hhs.gov
Source: Centers for Medicare & Medicaid Services

AHRQ grants aim to improve patient safety, reduce costs due to malpractice fallout

AHRQ grants aim to improve patient safety, reduce costs due to malpractice fallout: "

In an attempt to curb the costs involved with lawsuits in malpractice cases nationwide, the Obama administration is enlisting the help of the New York State Unified Court System--and in particular city-based Judge Douglas McKeon, whose innovative idea of 'judge-directed negotiations' has saved hospitals as much as $50 million per year, reports the Associated Press.

The Agency for Healthcare Research and Quality is funding seven overall "demonstration grants" worth a total of $19.7 million. The projects are aimed primarily at implementing and evaluating evidence-based patient safety initiatives and medical liability projects. McKeon's idea--for which New York is being paid close to $3 million--is to reduce malpractice costs, not only through what appear to be more involved conflict resolution efforts, but also by ensuring that hospitals disclose their mistakes earlier and with more honesty.

McKeon says he brings what he calls "humanness" to the process of deciding his cases, talking to suffering plaintiff family members and asking more about the actual people involved in such instances, rather than simply focusing on settlement figures.

Ultimately, AHRQ director Carolyn Clancy believes ideas like McKeon's will help to improve patient safety by discouraging the practice of defensive medicine; such a practice tends to be more prevalent when doctors fear retribution, lawsuit style, for even the smallest of blunders.

'This will get us better evidence of what works both to reduce costs, and to improve basic patient safety,' Clancy said, according to the AP. "That will be a critical part of future solutions."

Along with the seven demonstration grants, the AHRQ also is disseminating $3.5 million worth of "planning grants," which will be spread to 13 different entities nationwide. The ultimate goal of the planning grants is to "create detailed plans for patient safety and medical liability reform," according to the AHRQ's website. None of the 13 individual grants is worth more than $300,000.

To learn more:
- read the AP article
- here's the AHRQ's summary of the demonstration grants
- here's the summary of the planning grants

Related Articles:

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Cardiologists admit to practicing defensive medicine
Doctors' fear of lawsuits takes a hefty financial toll
The philosophy behind Michigan's 'I'm Sorry' program

New knowledge of radiation risks prompts FDA, providers to make changes

New knowledge of radiation risks prompts FDA, providers to make changes: "
The United States accounts for half of the advanced procedures that use radiation in the world. But the CT scans and chest X-rays that have proven convenient and popular among doctors looking for quick answers to provide patients and their families have also led to a six-fold increase Americans' exposure to dangerous radiation over the last 20 years.
Amid recent attention to the previously unseen risks of cumulative doses of radiation on individuals as well, as errors in adjusting machine for a patient's age and size, the U.S. Food and Drug Administration has taken steps to address the problem, including possibly requiring device makers to print the radiation dose on each image and getting doctors to set standard doses for common procedures, reports the Associated Press.
Individual healthcare providers also are becoming increasingly aware of the dangers of too much radiation, particularly for younger and female patients, and have implemented their own process changes. For example, the diagnostic imaging team at Yampa Valley Medical in Colorado uses a technique called ALARA, which means a radiation dosage 'as low as reasonably achievable.'
This means that when a physician orders a CT scan, the order is reviewed by a radiologist before the radiographer sets the imaging equipment based on the patient's body weight so that the correct dosage of radiation will be used, explains an article in Steamboat Today. In addition, YVMC has a physicist calibrate its radiology equipment annually to ensure it is within the manufacturer's specifications and national standards.
The most overused tests, according to the International Commission on Radiological Protection, include routine chest X-rays when people are admitted to a hospital or before surgery; imaging tests on car crash victims who don't show signs of head or abdominal injuries; and lower-back X-rays in older people with degenerative, but stable, spine conditions.

To learn more:
- read this Associated Press article on Yahoo! News
- see this piece in Steamboat Today

Related Articles:
Study: Imaging tests almost double Americans' radiation exposure
Most CT scans may be unnecessary
FDA looking to reduce radiation exposure to patients
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Catching Up with the New CIO at NYC Health and Hospitals Corporation

Catching Up with the New CIO at NYC Health and Hospitals Corporation: "On March 1, Norberto (Bert) Robles assumed the role of Senior Vice President of Information Technology and Corporate Chief Information Officer at the New York City Health and Hospitals Corporation (NYCHHC). Robles most recently served as CIO for the State University of New York Downstate Medical Center, and is a member of the College of Healthcare Information Management Executives (CHIME). NYCHHC is a $6.3 billion integrated healthcare delivery system with its own 350,000 member health plan, and is the largest municipal healthcare organization in the country. An early adopter of electronic health records, NYCHHC has more than 10,000 users online daily. It also has CPOE and electronic patient registries that monitor and improve the health of diabetic and heart disease patients across the 11-hospital system. HHC serves 1.3 million New Yorkers yearly and provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six diagnostic and treatment centers and more than 80 community-based clinics and. HHC Health and Home Care. Healthcare Informatics senior associate editor Daphne Lawrence recently spoke with Robles about his new role.

Noninvasive Diagnostic Imaging Utilization Rates For The Medicare Population Vary Geographically

Noninvasive Diagnostic Imaging Utilization Rates For The Medicare Population Vary Geographically: "The utilization rates of noninvasive diagnostic imaging procedures such as computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) for the Medicare population vary substantially from region to region, with Atlanta, GA, having the highest utilization rate and Seattle, WA, having the lowest, according to a study in the April issue ..."

A Consumers' Guide To Health Reform

A Consumers' Guide To Health Reform: "Kaiser Health News staff writer Phil Galewitz writes about the impact of the legislative package approved yesterday by the House of Representatives. 'The health overhaul package passed by the House Sunday and sent to the Senate for final action is the most far-reaching health legislation since the creation of the Medicare and Medicaid programs' (Galewitz, 3/21). Read the entire story.
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Concerns About Unnecessary Scans And Radiation Risk Prompt Reviews By Doctors

Concerns About Unnecessary Scans And Radiation Risk Prompt Reviews By Doctors: "Business Week reports on a study that finds 1 in 4 MRI and CT scans are inappropriately recommended by doctors. The study appears in the March issue of the Journal of the American College of Radiology. The researchers analyzed 459 scans at Harborview Medical Center in Seattle. ''Of the 459 reviewed, 74 percent were considered appropriate and 26 percent were considered inappropriate..."

CMIO 2010 Compensation Survey: The Results Are In!

CMIO 2010 Compensation Survey: The Results Are In!
Chief medical information officers and other medical informatics directors tend to love their jobs and want to stick around for a while, even though this is a relatively new position for many organizations, according to a survey of this discipline by CMIO magazine.
Two-thirds of the 118 CMIOs who took the online survey said they were "very satisfied" or "somewhat satisfied" with their compensation and 86 percent indicated they had no immediate plans to leave their jobs. The majority of CMIOs earn between $180,000 and $300,000 annually in base salary, though a third of survey respondents make less than $180,000 a year. Nearly half did not receive a bonus in 2009, reflecting the moribund economy, though 56 percent say they expect to get one this year.
Their top IT priorities for 2010 include reducing medical errors, delivering clinical knowledge to practicing physicians and implementing EMRs, while on the business side, CMIOs are planning on concentrating on EMRs, CPOE and clinical decision support this year.
Other notable findings:
* 93 percent of CMIOs are men
* 68 percent currently practice medicine
* 36 percent report to the CIO, 31 percent to the CMO and 13 percent directly to the CEO
For more data and analysis: - check out this CMIO feature

FDA looking to reduce radiation exposure to patients

FDA looking to reduce radiation exposure to patients: "
With growing reports of unnecessary radiation exposure to patients, the Food and Drug Administration has stepped in to require safety controls that will eliminate excessive radiation doses, and also will work to develop best-practice measures.
Examples of the growing problem include patients who weren't told of radiation exposures in California, veterans receiving incorrect doses in Philadelphia, and a 2009 study that shows increasing radiation exposure to patients.
The average American's total radiation exposure has nearly doubled since 1980, largely because of CT scans, according to recent studies, including one by the New England Journal of Medicine. Medical radiation now accounts for more than half of the population's total radiation exposure; it used to be just one-sixth.
Tuesday's announcement comes five months after FDA began looking into reports of problems with CT scanning at Cedars-Sinai Medical Center in Los Angeles that went on for 18 months before being noticed. More than 200 patients were exposed to excess radiation.
The FDA's efforts will extend to other high-dose types of radiation procedures, including nuclear medicine and fluoroscopy. Nuclear medicine involves injecting nuclear particles into the body to diagnose problems with organs, such as the heart and lungs. Fluoroscopy uses a continuous X-ray beam to view body parts in real time.
A public hearing is set for March on this initiative, and the FDA will work with CMS to create key quality assurance practices. The FDA will then try to work those practices into the mandatory accreditation and Conditions of Participation processes for imaging facilities and hospitals.
To learn more: Read this FDA press release

ACR Designated a National Medical Imaging Accrediting Body by CMS

ACR Designated a National Medical Imaging Accrediting Body by CMS: "The Centers for Medicare and Medicaid Services (CMS) has selected the American College of Radiology (ACR), the nation’s oldest and most widely recognized medical imaging and radiation oncology accrediting body, as a designated accrediting organization for medical imaging facilities, able to satisfy all accreditation requirements for providers of advanced medical imaging mandated by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)."