HCA Advanced Imaging Management (AIM) Work Group - DOC by joI8Pj


									    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.

      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

    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

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