The Impact on Radiology Utilization of Disseminating an Analysis on the Value of Neuroimaging Studies in Intracerebral Hemorrhage: The University Hospitals Case Medical Center Comprehensive Stroke Center Experience (P5.145)

Abstract

OBJECTIVE: We sought to affect the resource utilization of medically unnecessary neuroimaging studies in patients hospitalized for ICH. BACKGROUND: A prior analysis of the impact of serial neuroimaging studies on medical decision making for patients with Intracerebral Hemorrhage (ICH) suggested that many neuroimaging studies could be safely omitted. DESIGN/METHODS: With IRB-approval, all patients with ICH (ICD 431) admitted to UHCMC in 2010 were previously reviewed and data collected on neuroimaging studies and their impact on medical decision making. Findings were presented at multidisciplinary clinical and research conferences and incorporated into a Hemorrhagic Stroke clinical practice guideline. Radiology utilization data for CT and MRI was collected on all patients with ICH admitted to UHCMC from 1/1/2010- 6/30/2013. RESULTS: % Resource Case Use, defined as resource cases per total cases for the specified time period, for CT was 86.39% (2010), 85.14% (2011), 79.74% (2012) and 78.41% (2013, quarters 1, 2). % Resource Case Use for MRI was 42.18% (2010), 39.19% (2011), 37.91% (2012) and 28.41% (2013, quarters 1, 2). The R2 for CT utilization was 0.9344 and for MRI utilization was 0.8538. CONCLUSIONS: Disseminating the findings of our prior analysis regarding the use of neuroimaging studies for patients with ICH at our institution led to a significant reduction in resource case use for CT and MRI. Neuroimaging resource utilization, fostered by the availability of sophisticated neuroimaging, EMR standard order sets, and clinical trials protocols is an important area for research on the value of our health care. Healthcare value analyses should be driven by medical decision making, patient outcomes and risk then extend to resource utilization and cost. Study Supported by: NA

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