Safe, Appropriate, and Patient-Centered Imaging

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Cathy Story PE APPROVEDBy Cathy Story, BS, CRA, FAHRA

The American Board of Radiology Foundation (ABRF) is an organization focused on creating a high-functioning, well-coordinated health system in which medical imaging and radiation are used safely and appropriately to deliver all the benefits that can be realized, while minimizing risk and waste.

I was honored to be asked to attend their National Medical Imaging Summit in Bethesda, MD in August 2013 as a representative of the AHRA Board of Directors. The topic was “Advancing the National Strategy for Safe, Appropriate, and Patient-Centered Imaging.” This topic was extremely timely as institutions are focusing more on patient satisfaction scores as we strive to deliver the best care possible to our patients. These scores can also be directly tied to reimbursement, so there is extra incentive to pay strict attention to the wants and needs of our patients. Our patient population is becoming more informed about safe and appropriate use of ionizing radiation, and they often question radiation safety practices and dose management.

The attendee list of the summit was quite varied and included representatives from the FDA, The Joint Commission, CMS, Blue Cross/Blue Shield, RSNA, and the ACR, just to name a few.  Specialists from orthopedics, dentistry, neurology, nursing, anesthesia, and emergency medicine came together with radiologists, medical physicists, and imaging administrators and directors for two days to brainstorm about safe and appropriate delivery of care related to imaging practices.

Each attendee was assigned to a priority group breakout session and a perspective.

The first priority group’s topic was “the optimization of medical imaging through safety and quality.” Their task was to:

  • Establish a safety culture and encourage its adoption through guidelines, requirements, and incentives for clinical personnel and facilities
  • Reduce risk by eliminating avoidable hazards and mitigating unavoidable hazards
  • Provide patients and referring physicians with the risk/benefit information they need to make informed decisions about imaging
  • Advance imaging science and technology to increase benefit and decrease risk.

The second priority group’s topic was “appropriateness and stewardship of medical imaging.” Their breakout group had to:

  • Ensure appropriate utilization of medical imaging (ie, neither overuse nor underuse)
  • Exercise stewardship at the individual practitioner and system levels
  • Ensure patient-centered imaging

The different perspectives that members in each group were assigned were:

  • Patients and their family members
  • Imaging professionals
  • Referring physicians
  • Hospital leadership

I found it particularly interesting to hear the opinions of those not directly tied to imaging, such as the anesthesiologist in my group.  He was genuinely concerned about the issues we face with safe and effective dose delivery and the many misconceptions of imaging by both those in the medical field and the general public.

At the end of the last session participants were given the opportunity to share with the entire group their pledge for how they will advance the safe and appropriate use of imaging over the next six months. In the words of one radiologist, “I pledge to take the time to educate my physician colleagues to order the correct test the first time.”  Another attendee vowed to “spend time with our student technologists so that they feel prepared to address concerns expressed to them by their patients in regards to radiation safety practices and dose delivery.”

At the conclusion of the summit the participants expressed renewed enthusiasm for advancing patient centered imaging in their institutions and sharing their learnings with their colleagues.

It is important for AHRA to continue to have representation at these types of national meetings so that we can have a voice on the important issues. Our attendance at these meetings will also serve as vehicle to solidify AHRA’s position as the leader in medical imaging management.

Cathy Story, BS, CRA, FAHRA is the administrator of diagnostic services at Lehigh Valley Health Network in Allentown, PA. She can be reached at

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