POTUS, personalized medicine + patient engagement

It’s a big week in radiology. For starters, it appears that there might be the tiniest bit of traction, at last, in closing the pernicious Stark loopholes. Multiple research studies and a policy statement suggested healthcare may be making strides toward personalized cancer screening. And finally, a photolog and video demonstrated the potential power of patient engagement.

The Obama administration’s proposed budget for FY 2014 represents a mixed bag for imagers. On the plus side, the proposal recommends closing the in-office ancillary services exception to the Stark law, which is projected to save the government more than $6 billion over 10 years. However, the budget also supports third-party prior authorization for select imaging services through radiology benefit managers, a strategy decried by many in the imaging community for its failure to deliver promised cost savings.

Colorectal cancer screening is plagued by dismal patient compliance. Although CT colonography (CTC) has been suggested as a strategy to improve compliance, there is no national reimbursement for the exam in the U.S. Research published in the Journal of General Internal Medicine detailed two key findings: Most physicians appropriately ordered the exam prior to 2009 when the Centers for Medicare & Medicaid Services provided coverage and availability of the exam may have increased patient compliance.

The flagship academic medical center in the Badger State, meanwhile, has circumvented the national policy and secured local reimbursement for CTC via robust radiology leadership. Check out the short video for some inspiration.

Stakeholders also presented thought-provoking paradigms in prostate and breast cancer screening this week. The American College of Physicians espoused a strategy of patient education and informed decision making regarding prostate-specific antigen testing. And research published in The American Journal of Medicine forecast the advent of personalized breast cancer screening. Like the CTC model at UW Health, personalized breast cancer screening requires close collaboration between imagers and clinicians.

Children’s Hospital of Pittsburgh of UPMC (CHP) tackled the tough task of engaging trembling tots with the launch of its Adventures Series imaging suites. The investment has cut pediatric sedation and wait times and improved throughput and satisfaction.  

While the CHP photographs are stunning, Cleveland Clinic held its own with a compelling video that asks providers to walk a mile in patients’ shoes. I guarantee it’s worth five minutes of your time.

On a final note, April 15 brings a new weekly feature in Health Imaging—the big question. Each Monday, an imaging expert addresses a pressing question confronting the profession in 500 words or less. On April 15, Richard Duszak, MD, CEO, Harvey L. Neiman Health Policy Institute, responds to the question: What is Imaging 3.0?

Do you have an idea for a big question or other feedback? Please email and let me know.

Lisa Fratt, editor