Medical imaging technology has been a target of ongoing efforts to reduce costs while maintaining quality of care. One of the ways in which the medical imaging community, through The American College of Radiology (ACR), is addressing this issue, is by partnering with the Choosing Wisely® campaign to focus on evidence-based guidelines that lead to appropriate use in medical imaging. With 34,000 medical imaging members, including radiologists, radiation oncologists and medical physicists, the ACR has stood at the vanguard of quality and safety efforts in medical imaging and radiation therapy.
Five Tests for Medical Imaging
In 1999, the American Board of Internal Medicine (ABIM) established The ABIM Foundation to advance medical professionalism and physician leadership in quality assessment and improvement. Choosing Wisely® is an initiative of the ABIM Foundation that aims to promote conversations between physicians and patients by helping patients choose care and medical imaging that is:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
In response to this challenge, national organizations representing medical specialists have been asked to “choose wisely” by identifying five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. You can view the five things physicians and patients should question regarding medical imaging here.
Medical Imaging Appropriateness Criteria
Medical imaging professionals also incorporate the ACR’s Appropriateness Criteria® which helps doctors prescribe the best medical imaging exam for a patient’s condition and reduce unnecessary scans. Some of the ACR’s recommendations for radiography technique include:
1. All medical imaging should be labeled with, patient identification, facility identification, examination date and time, and the side (right or left) of the anatomic site imaged.
2. All facilities performing medical imaging should have protocols for the standard view or views of each anatomic area of interest.
3. Appropriate collimation should be used to limit exposure to the anatomic area of interest.
4. All facilities performing radiography should have technique charts, or protocols for all anatomic parts.
5. Medical imaging should be reviewed for diagnostic quality before the patient is released. Repeat medical imaging should be performed as appropriate, when necessary for diagnostic quality.
6. All facilities producing medical imaging should have policies and procedures for appropriate shielding of patients.
What evidence-based medical imaging guidelines has your department or organization initiated?