RBMs, SPECT imaging share spotlight

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Chris P. Kaiser, Editor
The medical and commercial communities have issued strong objections to a provision calling for the use of radiology benefit managers (RBMs) as gatekeepers to unnecessary imaging in a budget signed by President Barack Obama.

The Medical Imaging and Technology Alliance (MITA) has called RBMs “an ineffective model that undermines the doctor-patient relationship in making healthcare decisions.”

GE Healthcare and Siemens Healthcare have pledged to fight the use of RBMs, saying that such a measure could negatively impact sales, add administrative costs and restrict access.

Even the Department of Health and Human Services (HHS) pointed out that no independent data exist on the success of RBMs in managing imaging services, after the Government Accountability Office (GAO) recommended their use to cut costs.

The American College of Cardiology and the American College of Radiology both oppose the use of RBMs and support education and training to ensure appropriate tests are ordered. Many stakeholders say the infusion of billions of dollars for modernizing IT infrastructure, including EMRs, will help cut costs due to unnecessary testing.

Interestingly, a study presented at the ACC meeting in Orlando found that an algorithm based on appropriateness criteria identified 13 percent of more than 6,000 SPECT myocardial perfusion studies as inappropriate. With feedback and education, practices in the pilot study were able to reduce inappropriate testing. Researchers concluded that such self-monitoring is feasible and could provide an alternative to RBMs.

Another study we are featuring in the Cardiac Imaging Portal shows that gated SPECT stress imaging is the best technique to predict future events in patients with stable ischemic heart disease. SPECT beat out left ventricular ejection fraction and coronary angiography as a prognostic test for future cardiac events.

To cap our news on SPECT, GE recently launched their version of an advanced SPECT camera. Like similar products on the market--such as D-SPECT or UltraSpect, which are also in the news--the advanced hardware and software reduces scanning time to about five minutes and reduces radiation dose.

We also are featuring several articles on CT, including a few dose-related studies and a mention of the fisrt U.S. installation of the Siemens Flash CT, a system that helps reduce radiation dose as well.

If you’re looking for more information about cardiac imaging technology, be sure to stop by our HealthCare TechGuide. Company and product listings, whitepapers and upcoming events are just a mouse click away. 

Also, be sure to check out our sister publication, Health Imaging & IT, which features a special section on Cardiac Imaging in the March issue. Articles include “Making the Business Case for Cardiac CT (Even in a Recession)” and “CVIS, Cardiology PACS Widening Image Access,” among others.

In addition, you should check our newest magazine, CMIO, dedicated to informing chief medical information offices about all they need to know regarding the ever-complicated world of information technology.

Lastly, if you have a comment or report to share about any aspect of cardiac imaging, please contact me at the address below. I look forward to hearing from you.

Chris P. Kaiser