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Minnesota Effort Helps Ensure Appropriate Imaging Tests

November 10, 2010
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The Institute for Clinical Systems Improvement (ICSI), a nonprofit organization whose members include 60 medical groups and six sponsoring health plans in Minnesota and surrounding states, has licensed RadPort, an electronic evidence-based, decision-support (e-ordering) system (supplied by Nuance Communications, Inc., Burlington, Mass.), to support a statewide initiative to help ensure Minnesotans only receive medically appropriate high-tech diagnostic imaging (HDTI) tests.

According to Nuance, the ICSI initiative is the first of its kind in the country, and is expected to save the Minnesota healthcare community more than $28 million annually. In addition, ICSI will use Nuance’s RadCube software solution to analyze physician-ordering trends in parallel with patients’ actual clinical outcomes.

“This is an exciting statewide initiative that will yield many patient, provider, health plan and community benefits, and potentially serve as a national model for how to help reduce the more than $100 billion spent annually on high-tech diagnostic imaging tests across the U.S,” says Cally Vinz, vice president of clinical products and strategic initiatives, ICSI. “With Nuance’s electronic decision-support and patient outcome analysis solution, we will work to guide appropriate ordering at the point-of-order to ensure the best exam is ordered for the patient every time. We will also have better insight into physician ordering habits and their impact on patient care.”

The initiative included a yearlong pilot program, in which more than 2,300 physicians from five Minnesota medical groups, five health plans (Allina Medical Clinic, Fairview Health Services, HealthPartners Medical Group, Park Nicollet Health Services, and St. Mary’s/Duluth Clinic Health System, BlueCross Blue Shield of Minnesota, HealthPartners, Medica, and UCare), and the Minnesota Department of Human Services used e-Ordering to order HDTI exams. The pilot showed that the exams ordered with evidence-based decision-support technology had an increase in medical appropriateness versus orders initiated without it. The pilot also showed that using decision-support appropriateness criteria in the physician’s office reduced patient exposure to unnecessary radiation, and contributed to a 0 percent increase in HTDI scans ordered in 2007 (following an 8 percent increase in Minnesota in 2006). During the time of the pilot, an estimated $28 million in healthcare cost savings was reported.

Since the pilot, all five medical groups have continued to use the decision-support criteria, according to Nuance. In total, it is estimated that by using e-Ordering for the past three years, the five medical groups have helped save Minnesota $84 million, as there has not been an increase in the use of HTDI scans in Minnesota since 2007.


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