Hi all,
I wrote and posted an article on LinkedIn concerning importance of checking your DIR data if you are planning to use it to meet the 2018 QPP reporting requirements. The article is titled Using the DIR to Meet CMS's Quality Reporting Requirements in Radiology: Important Information You Need To Know.
Essentially, it is no longer enough to participate in the DIR to meet the DIR Measures – in 2018 QPP success is determined by the doses you submit for the three qualifying Measures – CT Abd/Pelvis w/ contrast; CT Chest /wo contrast; and, CT Brain /wo contrast. If your doses are above the Diagnostic Reference Level (DRL) for a Measure no credit will be awarded for that Measure; and, while doses below the DRL will qualify for the Measure, the quality score awarded will be determined by how the reported doses compare to others, i.e., the lower the dose the higher the quality score. The challenge for many hospital-based practices is that much of the DIR oversight and management/mapping duties are performed by hospital personnel, most often a facility technologist, often with little to no involvement by the radiology group management team. As I write in the article,
"This has interesting implications for the radiologist. While not complicated, exam mapping is nuanced, and therefore, the person performing it should have a working understanding RadLex Playbook Identifiers (RPID), the exam name mapping nomenclature, and how to perform the exam name mapping crosswalk to the Dose Index Registry. Without adequate understanding of how RPIDs fit into the DIR it is easy for the person mapping studies to innocently mis-map studies, which can and will lead to undesirable outcomes for radiologists' QPP reporting, while having no noticeable impact or consequences at the facility level. Additionally, even if the exam name mapping is correct, it is possible for the dose reported to the DIR to be inappropriately inflated. This can occur at the time of the exam if the technologist selects an incorrect protocol or misapplies the selection."
Some errors are retroactively correctable if done in time (e.g., exam name mapping errors), while others issues like changes to high scan parameters to lower doses only affect studies going forward. In either case, if you plan to use the DIR you should review your reports and make appropriate changes.
To read the entire article click here.
Mike Bohl, COO
Radiology Group, PC, SC
1970 E 53rd St.
Davenport, Iowa 52807
563.421.5656
mbohl@rgimaging.com
Bohl Radiologic Technologist Scholarship Fund
Mercy College of Health Sciences, Des Moines, IA
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