Value drives next steps in imaging lab accreditation

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Imaging laboratory accreditation is adapting to meet the needs of today’s value-based healthcare system, according to an essay published in the February issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.   

Geoffrey A. Rose, MD, of Carolinas HealthCare System in Charlotte, N.C., and Neil J. Weissman, MD, of the MedStar Health Research Institute, co-authored a paper that described the past, present and future of imaging lab accreditation. They emphasized the challenges of evaluating the clinical impact of cardiovascular imaging and the use of quality assessments focusing on structure, process and outcome.

They traced the impetus for accreditation to 1990 with the formation of the Intersocietal Commission for the Accreditation of Vascular Laboratories, which developed peer-based standards for accreditation. Accreditation became a badge of quality, and because the process included feedback, it fostered quality improvement as well.

In 2008, the commission merged with imaging bodies representing echocardiography, nuclear cardiology and other disciplines to form the Intersocietal Accreditation Commission (IAC), where Rose is chair. The consolidation coincided with federal legislation that required accreditation for reimbursement, with IAC being one of three recognized accreditation organizations.

According to Rose and Weissman, the IAC’s goals include efforts to simplify the multimodality accreditation process, create standardized quality improvement guidelines and launch an internally funded research program, among other initiatives. The research is designed to elucidate the relationship between laboratory accreditation and cardiovascular imaging quality and value.

“It is through a program of research that we hope to get beyond today’s baseline of expert consensus to a more informed and validated approach that links laboratory performance and clinical quality,” they explained.

Rose and Weissman cited a forum attended by government representatives, payers, physicians, patient advocates, sponsoring societies and technical staff to discuss ways to improve accreditation and make it more meaningful. Various participants proposed that the process was too lax, too stringent, too time-consuming and too expensive.

As a result, IAC is reviewing comments to incorporate into action plans. “Further research linking accreditation, outcomes and value, along with ongoing feedback from stakeholders, will help continue to refine the process and meet the medical community’s needs,” they concluded.