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Stewardship Could Improve Appropriate Medical Imaging Use

Stewardship model could guide use to improve clinical outcomes and create value at point of care

FRIDAY, Oct. 30, 2015 (HealthDay News) — Stewardship may be a promising approach for improving appropriate use of medical imaging technology, according to a perspective piece published in the Oct. 29 issue of the New England Journal of Medicine.

Noting that in addition to playing an essential role in diagnosis and management, medical imaging technology has recently become known for its low-value uses, Daniel J. Durand, M.D., from the Johns Hopkins School of Medicine in Baltimore, and colleagues discussed the need for better stewardship.

The authors described two recent policy changes that have created a more favorable environment for provider-led stewardship: movement toward payment reform and a section of the Protecting Access to Medicare Act of 2014, which mandates that physicians reference appropriateness guidelines from provider organizations when ordering advanced imaging. Health care leaders should signal a transition away from easy imaging access and toward stewardship as part of a quality-improvement strategy. Stewardship programs should be led by imaging specialists, with referring physicians playing a role in shaping local concepts of appropriate imaging. Clinical decision support systems can be an enabling tool and can provide a useful infrastructure to support stewardship.

“Ultimately, health system leaders, referring physicians, and imaging specialists may take the concept of stewardship in new directions, developing a more robust stewardship model that encourages the use of imaging technology to improve patient outcomes and more reliably create value at the point of care,” the authors write.

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