News | Clinical Decision Support | July 18, 2019

Johns Hopkins Named Qualified Provider-led Entity to Develop Criteria for Diagnostic Imaging

Johns Hopkins becomes 22nd institution formally approved to design appropriate use criteria for ordering diagnostic imaging tests

Johns Hopkins Named Qualified Provider-led Entity to Develop Criteria for Diagnostic Imaging

July 18, 2019 — On June 30, 2019, the Centers for Medicare & Medicaid Services (CMS) announced the Johns Hopkins University School of Medicine has been designated a qualified provider-led entity (qPLE). This allows Johns Hopkins to develop criteria that meet the requirements of the federal Protecting Access to Medicare Act (PAMA) of 2014 when ordering diagnostic imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans and nuclear imaging in the emergency department and ambulatory settings.

Johns Hopkins joins 21 other institutions across the nation that CMS has formally approved to design these criteria.

“We are honored by this approval, as it dovetails nicely with our effort to improve the value of medical care in our health system and across the nation,” said Pamela Johnson, M.D., vice chair of quality and safety in the Department of Radiology, professor of radiology and radiological science at the Johns Hopkins University School of Medicine and director of the High Value Practice Academic Alliance. “Our goal is to deliver healthcare of the highest quality, safety, efficiency and effectiveness for our patients. By helping doctors and advanced practice providers use evidence in the literature at the point of care to know which tests to order, which treatments to prescribe and when patients can safely be discharged from the emergency department, we aim to avoid unwarranted variation in care and avoid unnecessary use of medical resources that does not add value, while delivering the best outcomes for our patients.”

Physicians learn best practices during their training. However, as healthcare and technology evolve and improve, medical best practices also must change. And while professional societies publish clinical practice guidelines annually, adopting change can be slow. “Studies estimate that it takes an average of 17 years for new evidence in the literature to translate into changes in practice by the greater medical community,” said Johnson. “We wanted to skip that 17-year delay and improve healthcare quality as quickly as possible so our patients start benefiting right away.”

Even before the Johns Hopkins University School of Medicine was designated a qualified provider-led entity, Johnson and colleagues had established teams of physicians from multiple specialties to review primary medical literature and identify the best data to use to design the criteria. After mining the data and writing the criteria, the Johns Hopkins teams integrated them directly into diagnostic decision-making guidelines in the electronic medical record (EMR) system used by the hospitals and ambulatory practices in the Johns Hopkins Health System. From the EMR system, clinicians can access calculators, forms, consultation guides, videos and other resources to make it easier to locate the latest knowledge and best practices when they diagnose and treat patients. To optimize care delivery for each patient, decision trees guide selection of tests and treatments according to clinical symptoms.

This effort resulted in more than 70 guidelines addressing both diagnosis and management for a range of clinical scenarios, such as chest pain and syncope, which have already been built into The Johns Hopkins Hospitals’ emergency department electronic medical record system. Preliminary analyses confirm improvements in care delivery — for example, adhering to the chest pain guideline reduced the number of patients with noncardiac chest pain who were admitted to the hospital unnecessarily. All Johns Hopkins Health System adult emergency departments are now implementing these guidelines.  

Johns Hopkins’ new qPLE status will allow its experts to write criteria that can be used to guide physicians’ use of diagnostic imaging tests as required by the CMS Appropriate Use Criteria (AUC) Program, beginning with eight clinical priority areas: 

  • Chest pain; 
  • Pulmonary embolism; 
  • Neck pain; 
  • Low back pain; 
  • Shoulder pain; 
  • Hip pain; 
  • Headache; and 
  • Lung cancer. 

Johns Hopkins plans to make the criteria available to other care providers across the nation by January of next year, when CMS will require all healthcare professionals to consult clinical decision support tools when ordering advanced diagnostic imaging tests for Medicare patients.

“While CMS is focused on advanced diagnostic imaging tests, we at Johns Hopkins are keen to ensure best practice across all aspects of medicine and surgery both within our institution and nationally,” said Johnson. “Our rigorous evidentiary literature review coupled with the clinical expertise of the multidisciplinary teams will hopefully refine the practice of medicine so that patients get tests and treatments that add value to their care and benefit from advances in practice more efficiently than they have traditionally.”

Watch the VIDEO: Clinical Decision Support of the Future

For more information: www.hopkinsmedicine.org

Related Content

VIDEO: AHRA Regulatory Update Part 1: Clinical Decision Support

ACR Appropriateness Criteria Now Satisfy Federal AUC Requirements

Related Content

The key trends Clinicians reviewing a COVID-19 patient's lung CT that reveals the severity of COVID-caused pneumonia. The impact of COVID on radiology was a major, over arching trend at  the 2020 Radiological Society of North America (RSNA) meeting. Getty Imagesbserved at 2020 Radiological Society of North America (RSNA) meeting all focused around COVID-19 (SARS-CoV-2) and the impact it has had on radiology. #RSNA #RSNA20 #RSNA2020

Clinicians reviewing a COVID-19 patient's lung CT that reveals the severity of COVID-caused pneumonia. The impact of COVID on radiology was a major, over arching trend at  the 2020 Radiological Society of North America (RSNA) meeting. Getty Images

Feature | RSNA | January 20, 2021 | By Melinda Taschetta-Millane and Dave Fornell
Vendor neutral archives enable a single, central location to store large volumes of radiology data, but now need to be able to house data from dozens of other departments with a wide array of data formats. This article originally ran as an introduction to the Vendor Neutral Archives comparison chart.
Feature | Vendor Neutral Archive (VNA) | January 20, 2021 | By Dave Fornell
Most radiologists and clinicians are not trained as...
AI Metrics, LLC, a medical imaging startup focused on augmented intelligence to improve patient care, announced today that the U.S. Food and Drug Administration (FDA) has granted 510(k) clearance for the company’s flagship image analysis platform.
News | Artificial Intelligence | January 18, 2021
January 18, 2021 — AI Metrics, LLC, a medical imaging startup focused on augmented intelligence to improve patient ca
The U.S. Food and Drug Administration released the agency's first Artificial Intelligence/Machine Learning (AI/ML)-Based Software as a Medical Device (SaMD) Action Plan. This action plan describes a multi-pronged approach to advance the Agency's oversight of AI/ML-based medical software.
News | Artificial Intelligence | January 12, 2021
January 12, 2021 — The U.S.
OptumInsight and Change Healthcare combine to advance a more modern, information and technology-enabled healthcare platform

Getty Images

News | Information Technology | January 06, 2021
January 6, 2020 — Optum, a diversified health services company and
#coronavirus #COVID19 #pandemic

Getty Images

News | Radiology Imaging | January 01, 2021
The Imaging Technology News (ITN) team wishes you a Happy and Healthy New Year!
Company delivers on last year’s roadmap milestones and continues to advance cloud-native suite of tools to lead industry to the future of enterprise imaging
News | Enterprise Imaging | December 23, 2020
December 23, 2020 — ...
 EvoHealth, a trailblazer in incorporating new technology in healthcare IT software, announced it has exceeded its first milestone of more than 100 customers with over 200 locations.
News | Information Technology | December 22, 2020
December 22, 2020 — EvoHealth, a trailblazer in incorporating n
Intelerad Acquires Digisonics CVIS and OB?GYN reporting systems to Expand its Enterprise Imaging Workflow
News | Enterprise Imaging | December 16, 2020
December 16, 2020 - Intelerad Medical Systems, a provider of...