Justine Cadet, Executive Editor

Nuclear cardiologists are increasingly forced to focus on practice management considerations, in addition to improving the clinical outcomes of their patients, during this time of uncertainty in the evolving U.S. healthcare model. Thus, ensuring that their labs are compliant and adhering to new regulations and transparency expectations are increasing in importance; yet, some U.S. practices are scrambling to catch up.

For instance, recent data from the Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL) suggest that while non-compliance with reporting standards is found in the majority of U.S. nuclear cardiology laboratories (57.2 percent), facilities that participate in the accreditation process demonstrate an increase in compliance over time. The study, which assessed 1,301 labs applying for accreditation from Jan. 1, 2008, to Jan. 1, 2009, was published online June 19 in the Journal of Nuclear Cardiology.

Of the 18 ICANL nuclear cardiology reporting standards, the most frequent non-compliant items were: missing date of report (26.4 percent); separate stress and imaging reports (23.6 percent); missing the route of administration of radiopharmaceutical (22.8 percent); and no mention of the defect size, severity, type and location using standardized terminology (defect quantification, 19.8 percent).

“We now know that accredited facilities are more likely to provide referring physicians with the accurate, standardized information they need to provide quality patient care, reducing the need for unnecessary and repetitive testing,” wrote lead author Peter L. Tilkemeier, MD, a nuclear cardiologist at Miriam Hospital in Providence, R.I.

Yet, these practice standards will be held to particular scrutiny, as volume continues to increase in the outpatient setting and reimbursement declines. While new patient office visits have spiked in the recent years, the number of office consults have declined, according to MedAxiom.

The firm reported that the average number of outpatient echocardiography exams per cardiologists was 194 in 2000 and 503 in 2010; however, nuclear outpatient imaging has stayed flat but declined on a per office encounter basis. In addition, while stress echo has increased, SPECT and PET imaging also have remained flat.

Revenue and income are decreasing, and physicians are working harder for less money, said Patrick White, president of MedAxiom, during a recent webinar. While he said that the government has turned its focus toward accountable care organizations, it is still unknown how they will fit into the healthcare mix.

The considerations are forcing physicians to think almost as much about practical matters as they do about clinical outcomes. Let us know how you’re tackling these challenges.

Justine Cadet
jcadet@cardiovascularbusiness.com