By Priscilla F. Butler, MS, FACR, FAAPM, Krista Bush, MBA, RT (R)(M)(CT), and Pam Kassing, MPA, RCC, FRBMA
The American College of Radiology (ACR) has accredited more than 38,000 facilities in 10 imaging modalities. These include breast MRI, breast ultrasound, CT, mammography, MRI, nuclear medicine and PET, radiation oncology, stereotactic breast, and ultrasound. ACR accreditation ensures that the physicians supervising and interpreting medical imaging meet stringent education and training standards, that the imaging equipment is surveyed regularly by qualified medical physicists to ensure that it is functioning properly, and that the technologists administering the tests are appropriately certified.
The Medicare Improvements for Patients and Providers Act (MIPPA) mandates that providers of outpatient advanced diagnostic imaging services (MR, CT, PET, and nuclear medicine) be accredited in order to receive payment for the technical component of those services. The ACR’s programs help to ensure compliance with this law.
ACR also accredits the modalities mandated under the Mammography Quality Standards Act (MQSA). Mammography has been proven to decrease breast cancer mortality. The MQSA standards have undoubtedly raised the quality of mammography being performed nationwide.
Accreditation is a two-step process. As part of the first step, sites are asked to provide the ACR with information regarding the practice site characteristics (ie, personnel) and modality-specific information (including equipment). Clinical images are required in the second step. Depending on the specific modality, scanning protocols, patient reports, phantom images, and dose measurements are also required for the second step. Information may also be collected on modality-specific quality control and quality assurance programs. All personnel interpreting or performing a given modality must meet the qualifications specific to that modality. For all modalities, the ACR allows for alternative pathways for physicians that are not board certified in radiology.
In late 2014, the ACR sent out a survey to all of its accredited sites asking for their help to improve the accreditation programs. As a result of the survey, many improvements were made to streamline the accreditation programs for facilities while maintaining the integrity of the programs. For example, we have received numerous comments from sites regarding the requirement of regions of interest (ROIs) on the CT renal exam. We listened and ROIs are no longer a requirement. Some other examples of how the programs have been improved are: elimination of the specialty exams in CT and MRI, the number of exams required for ultrasound were cut in half, and additional exam choices and modules were added to make the programs more flexible.
In November 2015, a more robust, dedicated accreditation micro website was launched. Having a stand-alone accreditation website was another result of feedback we received from accredited facilities and was designed for an optimal user experience. The new website provides direct access to streamlined, easy-to-follow information about ACR modality accreditation, direct links to the online application system and electronic image submission database, tutorials on how to use the online application, testing materials and electronic image submission, an improved ACR accredited facilities search feature for patients, and easy access to links such as the diagnostic imaging center of excellence program and lung cancer screening center designation information. All accreditation requirements, including those for personnel, can be found on the new accreditation website at www.acraccreditation.org under the Program Requirements for each modality. Descriptions of all the revisions of the programs are outlined in the beginning of the document.
ACR Practice Parameters and Technical Standards
The ACR Practice Parameters and Technical Standards help advance the science of radiology and improve the quality of service to patients. They promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills, and techniques.
The ACR will periodically define new practice parameters and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients throughout the United States. Existing practice parameters and technical standards will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.
Each practice parameter and technical standard, representing a policy statement by the College, has undergone a thorough consensus process in which it has been subjected to extensive review, requiring the approval of the Commission on Quality and Safety as well as the ACR Board of Chancellors, the ACR Council Steering Committee, and the ACR Council. The practice parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice parameters and technical standards by those entities not providing these services is not authorized.
The ACR has many tools and resources related to quality and safety. Many of the programs include several of their own resources including continuously updated frequently asked questions. Please visit these sites and communicate any questions you have to the program or activity. The ACR Accreditation Program contact information is available here: http://www.acraccreditation.org/Contact-Us. Questions about the Registries should be sent to firstname.lastname@example.org. Call 800-227-5463 if you have questions about Appropriateness Criteria or Practice Parameters and Technical Standards.
ACR will have a booth at the AHRA Annual Meeting featuring its programs. Please stop by and learn more.
Priscilla F. Butler, MS, FACR, FAAPM, is the senior director and medical physicist, quality and safety; Krista Bush, MBA, RT (R)(M)(CT) is the senior director of accreditation; and Pam Kassing, MPA, RCC, FRBMA is the senior economic advisor at The American College of Radiology.