A new imaging efficiency measure developed by CMS to reduce CT scans in emergency departments may not accurately determine which hospitals are performing CT scans inappropriately, according to a new study published in Annals of Emergency Medicine.
Researchers reviewed medical records for 748 headache patients at 21 hospitals who underwent an inappropriate brain CT. Of those patients, 83 percent should not have been labeled as inappropriate based on either ACEP clinical policy guidelines or expert consensus standards. Specifically, when the patients' medical records were reviewed, researchers found 65 percent of the CT scans actually complied with Medicare's measure and another 18 percent of patients had valid reasons for the CTs documented on their charts.
Since the OP-15 measure was only 17 percent accurate in assessing which patients should receive a CT scan, researchers suggested the measure could have unintended consequences by "publicizing inaccurate information about clinical performance and rewarding hospitals based on unreliable data."
Researchers reviewed medical records for 748 headache patients at 21 hospitals who underwent an inappropriate brain CT. Of those patients, 83 percent should not have been labeled as inappropriate based on either ACEP clinical policy guidelines or expert consensus standards. Specifically, when the patients' medical records were reviewed, researchers found 65 percent of the CT scans actually complied with Medicare's measure and another 18 percent of patients had valid reasons for the CTs documented on their charts.
Since the OP-15 measure was only 17 percent accurate in assessing which patients should receive a CT scan, researchers suggested the measure could have unintended consequences by "publicizing inaccurate information about clinical performance and rewarding hospitals based on unreliable data."
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