Nationally, it is estimated that 20 to 30 percent of currently performed High Tech Diagnostic Imaging (HTDI) exams are medically unnecessary or inappropriate. There has been rapid growth of HTDI year after year with an overall 13 percent annual increase in utilization. Also, it is estimated that 1.5 to 2 percent of all cancers in the U.S. population may be caused by Computerized Tomography (CT) radiation exposure.

The American College of Radiologists (ACR) has published industry appropriateness standards. The Institute for Clinical Systems Improvement (ICSI) endorsed ACR standardized appropriateness criteria, which have been field tested and shown to improve appropriateness while holding utilization flat over a two-year pilot. Appropriateness testing will improve patient safety, reduce cumulative lifetime radiation exposure, promote physician and patient education, and slow health care cost increases linked to overuse of HTDI.

HTDI exams are currently scheduled without the benefit of a standardized, evidence-based, decision support tool. Pretest consultation with radiologists, although possible, occurs infrequently. Inappropriate testing contributes to unnecessary radiation exposure, decreased diagnostic efficiency, potential medical harm due to the pursuit of clinically irrelevant findings (incidentomas), increased patient anxiety due to false positive tests, and is a major cause of unsustainable increases in health care costs. A real-time, validated, decision support tool incorporated into the outpatient setting, including emergency departments, should lead to better choice of the preferred mode of imaging, improved patient safety and decreased waste.

Improved patient safety, increased quality of HTDI ordering and reduced costs will be achieved in the region through the implementation of HTDI appropriateness criteria in the outpatient setting of physician offices and the emergency departments. (Order the right test at the right time on the right patient).

High Tech Imaging Team

Team Lead: Dr. Carter Young, Central Illinois Radiology Associates
Black Belts: Cheryl Toland, Quality Quest, and Anoop Mahajan, CGN

Team Members: Greg Hill; CIRA General Counsel; Lisa Snyder, MD-IPMR; Rick Luetkemeyer, MD-Cat; Rick Horndasch, MD-Cat; Bob Meister, MD-Proctor; Alan Rakoff, MD-Proctor; Elaine Frye, OSF; Jared Rogers, MD-MMCI; Elsburgh Clarke, MD-MMCI; Greg Sowards, MD-MMCI; James Szudera, MD-Pekin; Dave Overlot-Decatur Memorial; Don Baker, MD-OSF; Mike Cruz, MD-OSF; Denise Graves-Consumer; Adriane Lisenko-Consumer; Robert Parker, MD-Health Alliance; Mike Namanny-MMCI