HCA Advanced Imaging Management (AIM) Work Group Meeting Summary – Tuesday, February 15, 2011 Attending Workgroup Members: Joe Gifford Regence; Bob Mecklenburg, Virginia Mason; Kelly Weaver, The Everett Clinic; Norm Beauchamp, UW Radiology/Medicine; John Espinola, Premera; Matt Handley, Group Health; Steve Hill, Chair By telephone: Verni Jogaratnam, CHPW; Will Callicoat, Providence Staff: Alexis Wilson, Leah Hole-Curry Puget Sound Health Alliance: Susie Dade Purpose: A core group of leading health care providers and payers in Washington have committed their organization to a collaborative effort to develop a statewide process for advanced imaging management and agree to participate in a 6 month planning phase. Agenda Welcome/Introductions Discussion of Phase 3 Summary Discussion of Potential Collaborative Draft HB 1311 discussion Wrap up Summary of Outcomes: The Chair opened the meeting and reminded the Workgroup that this was its last meeting. The outcome of today’s meeting would be to reach a consensus, or decide that a consensus could not be reached with an articulation of different points of view. The Workgroup discussed the Phase 3 Summary document, and differing viewpoints and concerns were expressed about the Recommendations. Members had a spirited discussion primarily about the first Recommendation, including the lack of a specific bypass or “gold carding” process, the limitations of the two recommended vendors, and the authority of the payers versus the purchasers of services in decision-making. Dr. Craig Blackmore, Chair of the Health Technology Clinical Committee (HTCC), joined the meeting by telephone and outlined several concerns with the Phase 3 Summary, such as the Workgroup’s lack of adherence to the six guiding principles, and that the Workgroup is not truly representative of the State of Washington. Dr. Bob Mecklenburg reviewed the model document he authored with Dr. Jeffery Thompson for a potential collaborative housed at the Health Care Authority. He stressed his desire to see innovative programs continue such as the VMMC’s internally developed imaging decision support system. Other members of the Workgroup and the Chair felt that while a model such as Dr. Mecklenburg proposed would be ideal, there is no funding to move forward with it and the model is outside the scope of current Workgroup activities. The Workgroup agreed to amend the final Phase 3 Summary to include a modification to Recommendation #1, and to add a paragraph above the four Recommendations in the Summary with the following: The Workgroup further acknowledges that DS systems build quality into the process of electronic image ordering at the point of service more directly than RBM systems, and RBM systems are not as consistent with the first guiding principle regarding decision support. However, the Workgroup also acknowledges that current conditions do not support rapid movement to a uniform DS system. These conditions include (1) provider group under-utilization of advanced imaging management systems (non-compliance); (2) rate of adoption of electronic health records with decision support capability at the point of service; and (3) unproven ability of a DS vendor to support implementation on a large scale. Given this, the Workgroup set both near and long term goals as follows: Recommendations from Phase Three 1) Near Term Goal: It is recommended that within the next 24 months, all payers and large provider systems within the state of Washington migrate to using a commercial vendor for managing utilization of the full set of procedures used in advanced imaging. The committee favors two vendors: American Imaging Management (RBM) or Nuance (DS). It will be within a Payer’s authority to exempt a specific provider group from participation in the selected vendor programs conditional upon meeting certain criteria. Next steps: o Staff will incorporate added comments to the summary document and circulate to Workgroup members for a vote to accept or not accept. o Steve Hill will work with members of the Workgroup who want to draft a second statement that addresses some of the remaining issues. o The AIM Planning Workgroup concluded its Phase Three activities and was adjourned.
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