Imaging e-Ordering Coalition Formed to Promote Evidence-Based Systems for Ordering Appropriate Diagnostic Tests

Healthcare leaders are promoting hospital information technology- (HIT)-enabled decision support tools to assure medically appropriate imaging tests for all patients--the right test, at the right time.

An alliance of leading healthcare providers, technology companies, and diagnostic imaging organizations has joined forces to form the Imaging e-Ordering Coalition (The Coalition; Washington DC, USA). This U.S. initiative will promote HIT-enabled decision-support (e-Ordering) as a solution to assure that all patients receive the most medically appropriate diagnostic imaging test for their specific condition.

Members of the Coalition are devoting their energies to help educate policy makers and healthcare providers about the patient-centered efficiencies of e-Ordering, as well as recommending to lawmakers that the efforts to build incentives for prescribing medications electronically (e-Prescribing) should be broadened to include diagnostic imaging e-Ordering solutions.

"As the healthcare industry, federal government and various regulatory bodies evaluate strategies to contain the rising cost of healthcare, e-Ordering is increasingly recognized as a cost-effective and data-driven approach to assure clinical best practices are applied to all ordering decisions,” said Bibb Allen, M.D., of the American College of Radiology (ACR; Reston, VA, USA), and founding member of the Imaging e-Ordering Coalition. "Expanding on the e-Prescribing model, e-Ordering will do for diagnostic imaging what e-Prescribing has done for the drug prescription process--simplify the way physicians' decisions for patient care are verified as medically appropriate and safe without compromising the physician-patient relationship.”

According to the Coalition, e-Ordering prevents many of the potential issues associated with radiology benefit managers (RBMs), which are organizations employed by some healthcare insurers to manage utilization and costs associated with high-tech diagnostic exams. Concerns with the RBM model include regulatory oversight and a manually burdensome "prior authorization” system whereby physicians must receive approval before ordering an imaging service. Under prior authorization, patients are often denied the imaging studies their physicians believe are warranted, are steered towards lower-precision tests that may not provide needed clinical information, or are forced to wait days or weeks to receive vital imaging services. e-Ordering, on the other hand, provides physicians real-time, electronic access to pre-exam, case-by-case decisions that are linked to published, evidenced-based clinical studies and are tailored to a patient's specific circumstances.

"The growing emphasis at all levels of the federal government to encourage adoption of HIT presents an opportunity for the Coalition to elevate e-Ordering as a much more provider-friendly, patient-centered alternative to the radiology benefit managers (RBM) model,” said Liz Quam, director, Center for Diagnostic Imaging Institute (Fort Walton Beach, FL, USA), and founding member of the Imaging e-Ordering 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 healthcare providers striving to offer patient-centered care. Using an electronic decision support tool offers regulators and insurers the assurance that the patient is receiving appropriate care without adding unnecessary time or administrative expense.”

To date, the following organizations are members of the Imaging e-Ordering Coalition: American College of Radiology, Center for Diagnostic Imaging (CDI), GE Healthcare (Chalfont St. Giles, UK), Medicalis (Kitchener, ON, Canada), Merge Healthcare (Milwaukee, WI, USA), and Nuance Communications, Inc. (Burlington, MA, USA).