A novel strategy that has saved Minnesota millions of dollars in unnecessary medical-imaging scans — and probably prevented dozens of patient deaths — might soon go national.
Leaders from Minnesota's medical and insurance communities met Monday morning to celebrate the project — which has leveled off the skyrocketing growth of MRI and CT scans for back pain, headaches and other problems — and to promote legislation by Rep. Erik Paulsen that would bring it to bear on the federal government's vast Medicare program.
Minnesota's "decision support" strategy, enacted in 2006, created a single set of standards for doctors to follow in deciding when patients need the costly scans. It also created a green-yellow-red coding system to show patients when scans were recommended and when they weren't. The use of such scans, which had been growing at a 7 percent annual clip, grew just 1 percent from 2007 to 2012.
"It happened immediately," said Cally Vinz, a vice president of health care improvement for the Institute for Clinical Systems Improvement, or ICSI.
The Bloomington-based collaborative advises Minnesota health plans, physicians and other providers on ideal medical policies and practices. One recent ICSI project aimed at improving efficiencies was the so-called DIAMOND program to assist primary care clinics in treating patients with depression.
ICSI estimates that the medical-imaging protocol has prevented $234 million in questionable or unnecessary scans, and 96 cancer-related deaths that would have been expected due to the radiation exposure that comes with CT scans, had use of the scans continued growing at previous rates.
And although patients sometimes want more and better medical tests, ICSI officials said patients are often glad to receive the "good news" that they don't need an imaging scan based on their condition, or that they should wait to see if other symptoms emerge first. Vinz recalled one woman whose doctor showed her that a proposed scan in her case would be in the "red" category, suggesting it wouldn't be worth the risk and the cost.
"Well, I don't want a red!" the woman exclaimed.