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The economics of quality and safety in radiology: Accreditation programs and landmark legislation

  • Author Footnotes
    1 Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Starr 8A, New York, New York 10065.
    Seth I. Stein
    Footnotes
    1 Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Starr 8A, New York, New York 10065.
    Affiliations
    Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NY, New York, United States of America
    Search for articles by this author
  • Author Footnotes
    1 Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Starr 8A, New York, New York 10065.
    Geraldine B. McGinty
    Correspondence
    Corresponding author at: Radiology and Healthcare Policy and Research, Weill Cornell Medicine, United States of America.
    Footnotes
    1 Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Starr 8A, New York, New York 10065.
    Affiliations
    Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NY, New York, United States of America
    Search for articles by this author
  • Author Footnotes
    1 Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Starr 8A, New York, New York 10065.
Published:December 05, 2019DOI:https://doi.org/10.1016/j.clinimag.2019.09.003

      Highlights

      • Increasing utilization of imaging for screening and diagnosis has necessitated guidelines and accountability to protect patients and radiology staff
      • Mammography Quality and Safety Act (MQSA) has served as a model for subsequent laws governing the quality and safety of other imaging modalities
      • The American College of Radiology (ACR) provides accreditation in multiple imaging modalities
      • ACR Centers of Excellence program provides accreditation, as well as outcomes and quality data to participating facilities
      • Financial penalties exist for facilities not complying with national quality and safety standards

      Abstract

      Quality and patient safety are essential to the practice of radiology. “Quality is our image” is the slogan for the American College of Radiology (ACR), which has embraced the quality and safety movement as a central tenet. The impact of advances in radiology on diagnosis and management of complex medical disorders cannot be understated. Nevertheless, these revolutionary technologies do come at a cost. Increasing utilization of advanced imaging in emergency departments throughout the country poses challenges both in terms of appropriate use and management of radiation dose. The indispensable place advanced imaging plays in diagnosis has necessitated guidelines and accountability to protect patients and radiology staff.
      In this series, we have created a concise discourse on what we have determined to be the essentials of the economics of quality and safety as it pertains to radiology. In this first article, we summarize the accreditation programs in radiology, their legislative background, and the associated financial and market responses that have subsequently resulted.
      We discuss the progression from historical predecessors to the passage of the Mammography Quality and Safety Act (MQSA), which served as a model for subsequent laws governing the quality and safety of other imaging modalities. These laws have had real economic implications for radiology practices seeking to meet new increasingly stringent guidelines. We also break down the costs of participation in the ACR accreditation and center of excellence programs.

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