R-SCAN’s goal is the ensure that every patient gets the most appropriate imaging test at the at the right time and for the right reason. R-SCAN’s core component is a collaboration between radiologists and referring clinicians to streamline imaging exam ordering in a sustainable fashion by teaching and implementing imaging-focused Choosing Wisely® recommendations.
The Choosing Wisely® campaign topics selected for the R-SCAN program are endorsed by multiple medical societies and aligned with the American College of Radiology’s evidence-based Appropriateness Criteria®. R-SCAN actively collaborates with various medical professional societies to promote multi-specialty involvement.
R-SCAN participants have access to Web-based tools and imaging clinical decision support technology to optimize imaging care, reduce unnecessary imaging exams and lower the cost of care. There is no cost to participate.
An R-SCAN project kicks off when referring clinicians and radiologists agree to form a collaborative care team to improve imaging exam ordering. The team selects a Choosing Wisely® topic that best fit the team goal for clinical improvement. An R-SCAN champion (either a referrer or radiologist) registers the team for R-SCAN participation.
The R-SCAN team carries out the clinical improvement activity in three phases — typically over a three- to six-month period. See the “R-SCAN How-To Guide” for more information.
Phase 1: Collect and Rate Cases
Team members collect cases, either retrospectively or prospectively, that the referring clinician’s practice ordered. The R-SCAN team determines how the cases will be reviewed — either by radiologists or, ideally, by a collaborative group of referring clinicians and radiologists.
A free, customized version of the ACR Select® clinical decision support tool—an electronic version of the ACR Appropriateness Criteria—is used to rate the appropriateness of imaging tests ordered for patients.
The R-SCAN team reviews reports (viewable only by the team) on the R-SCAN website that show results about the value of exams ordered. The reports identify opportunities for imaging exam ordering improvement.
Phase 2: Conduct Educational Activities
Based on the team’s recommendations for improvement, a range of educational activities can be selected and carried out. To support the educational program, the R-SCAN team can put to use a wide variety of resources available on the R-SCAN website, to include white papers, PowerPoint presentations, podcasts featuring radiologists and referring clinicians discussing imaging dilemmas and strategies, and imaging exam ordering self-assessments. A number of educational activities offer CME credits.
Phase 3: Assess Improvement
After the educational program, the R-SCAN team repeats the imaging exam collection and rating process from Phase 1 (with the same number of cases from the same Choosing Wisely topic). The R-SCAN team then reviews the report results to determine overall improvement in image ordering. Results in improvement can be shared with quality committees, hospital administrators and insurers to demonstrate the care coordination benefits.
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