Recent Studies Show MRI Utilization Can Lead to Better Clinical Outcome

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Derek R. Armfield, MD, co-founder and the Chief of Musculoskeletal Imaging of Foundation Radiology Group reviews recent a published study of the advantages of utilizing MRI to achieve an accurate patient diagnosis. Foundation Radiology Group employs a proactive quality program called SAFR (Strategically Aligned Foundation Radiology Quality Review) so that referring physician can be confident that the right exam was ordered for the patient. Employing such an approach can actually prevent costly surgical procedures or more expensive treatment.

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We at Foundation Radiology Group actively monitor utilization of services, but ultimately defer to what is going to provide the best patient outcome.

Healthcare cost increases have led providers and payers to scrutinize the use of certain clinical services. As a result, a lot of focus is being placed on proper utilization of diagnostic imaging. Many cite inappropriate ordering, self referral and defensive medicine as contributors to these cost increases. However, the clinician treating and seeing patients often finds it a necessity to seek additional insight in order to provide top level care through diagnostic testing that some have deemed to be excessive. We at Foundation Radiology Group actively monitor utilization of services, but ultimately defer to what is going to provide the best patient outcome.

In a recent presentation at the American Academy of Orthopaedic Surgeons(AAOS) Annual Conference in March 2012, Dr. S. Patel announced some interesting findings regarding the effectiveness of ordering a knee MRI. The presentation titled “Value of Knee Magnetic Resonance Imaging (MRI) in the Diagnosis and Management of Knee Disorders” disclosed that MRI frequently changes clinical diagnosis and patient management while improving diagnostic confidence, even when a clinical evaluation is performed by a highly specialized physician. This was most noticeable in the presence of lateral joint line pain and/or tenderness.

The purpose of this study was to determine how frequently the outcome of a MRI of the knee changes clinical diagnosis and management of a patient. The study also sought to prove whether certain characteristics of a patient or ordering physician can affect how knee MRI impacts diagnostic confidence and accuracy.

The study was conducted by three orthopedic surgeons and three sports medicine physicians from a single multispecialty practice who completed surveys on patients that received a knee MRI between June 2010 and January 2011. The pre-MRI survey recorded clinical history, symptoms, physical exam findings, diagnosis with confidence level and planned management. The post-MRI survey recorded diagnosis with confidence level and planned management.

Results showed that MRI changed the primary diagnosis in 29.3% of cases and patient management in 25.3% of cases. MRI changed management in 34.6% (18/52) of cases where a non-surgical management was planned, usually to either surgery or referral to an orthopedic surgeon in 94% of cases (17/18). MRI averted the need for surgery in 13.6% (three/22) of cases and changed the type of surgery in 12.5% (three/24) of cases.

To ensure the most accurate diagnosis for the patient, Foundation Radiology Group also relies on a proactive quality program for clinical assurance and issue review called SAFR (Strategically Aligned Foundation Radiology Quality Review). The program features benchmark imaging read accuracy rates over the national average – 99.6% vs. 96%. It is this type of diagnostic analysis that can help the physician community be confident that he/she ordered the right exam for the patient. Employing such an approach can actually prevent costly surgical procedures or more expensive treatment.

With outcomes based research we can better manage patient care to maximize exam utilization rather than being subject to system wide reimbursement cuts and excessive management of radiology benefits. This type of research approach along with an emphasis on sub-specialty reading, like we perform at Foundation Radiology Group, can help grow and maximize the care provided in orthopedics as well as other service lines. This ensures the highest standards for patient care.

About Derek R. Armfield, MD:
Derek R. Armfield, MD, is a co-founder of Foundation Radiology Group and the Chief of Musculoskeletal Imaging. As co-founder he has played an integral role in the organization’s growth, direction and development since its inception.

Dr. Armfield holds a B.S. in Chemical Engineering and an M.S. in Engineering Management from Stanford University. He received an M.D. and completed his residency from the University Of Pittsburgh School Of Medicine. Post residency, Armfield completed a Musculoskeletal Fellowship through the University of Pittsburgh.

About Foundation Radiology Group:
Foundation Radiology Group, founded to revolutionize the practice of radiology in community healthcare settings, combines the subspecialty services of a renowned, highly-trained physician team with a state-of-the-art technology solution to provide hospitals, physicians and patients access to a high-quality, elegant diagnostic imaging solution, with industry-leading, final diagnosis clinically relevant turn-around times.

Foundation Radiology Group's unique Elegant Radiology Model ensures comprehensive service line alignment by routing each patient study to the appropriate subspecialty radiologist. Foundation supports all hospital service lines including: Cardiovascular, Neurosciences, Orthopedics, Oncology, Women's Health, Gastroenterology, Pediatrics and Emergent/Ambulatory Care.

Foundation Radiology Group radiologists are all board certified, US-based providers. Our physicians and highly-skilled customer service team are available 24/7/365. For more information, visit, call 412-223-2272 or follow on Twitter@FoundationRad.

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Philip Feldstein
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