Value-Based Radiology in Canada: Reducing Low-Value Care and Improving System Efficiency

被引:1
|
作者
Yan, Tyler D. [1 ]
Jalal, Sabeena [1 ]
Harris, Alison [1 ]
机构
[1] Univ British Columbia, Dept Radiol, 2775 Laurel St,11th Floor, Vancouver, BC V5Z 1M9, Canada
关键词
value based radiology; low value; clinical decision support; sustainability; efficiency; HEALTH-CARE; ASSOCIATION; ERA; ACR;
D O I
10.1177/08465371241277110
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Radiology departments are increasingly tasked with managing growing demands on services including long waitlists for scanning and interventional procedures, human health resource shortages, equipment needs, and challenges incorporating advanced imaging solutions. The burden of system inefficiencies and the overuse of "low-value" imaging causes downstream impact on patients at the individual level, the economy and healthcare system at the societal level, and planetary health at an overarching level. Low value imaging includes those performed for an inappropriate clinical indication, with little to no value to the management of the patient, and resulting in healthcare resource waste; it is estimated that up to a quarter of advanced imaging studies in Canada meet this criterion. Strategies to reduce low-value imaging include the development and use of referral guidelines, use of appropriateness criteria, optimization of existing protocols, and integration of clinical decision support tools into the ordering provider's workflow. Additional means of optimizing system efficiency such as centralized intake models, improved access to electronic medical records and outside imaging, enhanced communication with patients and referrers, and the utilization of artificial intelligence will further increase the value of radiology provided to patients and care providers. Les demandes d'examen d'imagerie augmentent sans cesse et les services de radiologie doivent notamment g & eacute;rer les longues listes d'attente pour des examens d'imagerie et les proc & eacute;dures d'intervention, les p & eacute;nuries de ressources humaines en sant & eacute;, les besoins en & eacute;quipement et les enjeux li & eacute;s & agrave; l'adoption de solutions d'imagerie avanc & eacute;es. Le poids des inefficacit & eacute;s du syst & egrave;me et le recours excessif & agrave; des examens d'imagerie de << faible valeur >> ont des cons & eacute;quences sur les patients, sur l'& eacute;conomie et le syst & egrave;me de soins de sant & eacute; & agrave; l'& eacute;chelle soci & eacute;tale, et, de fa & ccedil;on plus globale, sur la sant & eacute; de la plan & egrave;te. Les examens d'imagerie de faible valeur comprennent ceux qui sont effectu & eacute;s dans le cadre d'une indication clinique inappropri & eacute;e, qui ont une valeur faible ou nulle pour la prise en charge du patient et qui entra & icirc;nent un gaspillage des ressources de sant & eacute;. On estime qu'au Canada, un examen d'imagerie avanc & eacute;e sur quatre r & eacute;pond & agrave; ce crit & egrave;re. Les strat & eacute;gies visant & agrave; r & eacute;duire l'imagerie de faible valeur comprennent l'& eacute;laboration et l'utilisation de lignes directrices relatives aux demandes d'examen, le recours & agrave; des crit & egrave;res de pertinence, l'optimisation des protocoles existants et l'int & eacute;gration d'outils d'aide & agrave; la d & eacute;cision clinique dans le flux de travail du prestataire de soins. D'autres strat & eacute;gies d'optimisation du syst & egrave;me, comme les mod & egrave;les d'admission centralis & eacute;e, l'am & eacute;lioration de l'acc & egrave;s aux dossiers m & eacute;dicaux & eacute;lectroniques et aux examens d'imagerie r & eacute;alis & eacute;s en externe, l'am & eacute;lioration de la communication avec les patients et les m & eacute;decins demandeurs, et le recours & agrave; l'intelligence artificielle augmenteront encore la valeur des services de radiologie fournis aux patients et aux prestataires de soins.
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页码:61 / 67
页数:7
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