Savings galore

Who doesn’t love a bargain? I surely do. Scanning this week’s headlines, I realized there are multiple bargains to be had in the imaging realm. Smart sites have cut repeat CT studies and applied algorithms to triage chest pain patients. Meanwhile, advances in imaging might fuel an uptake in watchful waiting and active surveillance of men with low-risk prostate cancer, which would translate into hefty savings.

The epidemic of repeat imaging in the emergency department presents a maddening challenge. Harborview Medical Center in Seattle treated the problem by constructing a virtual private network (VPN) that provides a mechanism for more than 120 referring sites to share transfer images. Post-VPN, the center saw proportionately lower CT utilization rates among transferred patients compared with direct-admit patients.

Researchers at University Medical Center Mannheim, Germany, addressed another common dilemma—triage of chest pain patients in the emergency department by implementing a computer-aided simple triage (CAST) system for automatic stenosis detection.

The technology can be employed to help physicians rule out stenosis on a per-patient and per-vessel level. CAST systems may be used to prioritize studies or assign more experienced readers to positive or low quality cases and less experienced to negative exams, according to the researchers.

Finally, overtreatment of low-risk prostate cancer remains a stubborn, and costly, challenge. Currently, fewer than 10 percent of men with low-risk disease opt for watchful waiting or active surveillance. If half of the men with newly diagnosed prostate cancer opted for watchful waiting, the resulting savings would surpass $1 billion, according to a study published June 18 in Annals of Internal Medicine.

In addition, the authors suggested that advances in molecular and imaging strategies could build support for watchful waiting and active surveillance.

How is your practice cultivating bargains? Please let us know.

Lisa Fratt, editor