The use of a learning community and online evaluation of utilization for SPECT myocardial perfusion imaging.

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Citation: Jacc: Cardiovascular Imaging. 6(7):823-9, 2013 Jul.PMID: 23643281Institution: MedStar Heart & Vascular InstituteDepartment: American College of Cardiology/Cardiology DivisionForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *Heart Diseases/ri [Radionuclide Imaging] | *Internet | *Myocardial Perfusion Imaging/ut [Utilization] | *Patient Selection | *Physician's Practice Patterns | *Social Networking | *Tomography, Emission-Computed, Single-Photon/ut [Utilization] | Algorithms | Coronary Circulation | Decision Support Techniques | Decision Trees | Guideline Adherence | Heart Diseases/pp [Physiopathology] | Humans | Myocardial Perfusion Imaging/mt [Methods] | Myocardial Perfusion Imaging/st [Standards] | Physician's Practice Patterns/st [Standards] | Practice Guidelines as Topic | Predictive Value of Tests | Program Development | Program Evaluation | Quality Improvement | Quality Indicators, Health Care | Software | Time Factors | Tomography, Emission-Computed, Single-Photon/st [Standards] | Unnecessary Procedures/ut [Utilization]Year: 2013Name of journal: JACC. Cardiovascular imagingAbstract: Resource-sensitive and quality-centered imaging begins with the selection of the appropriate patient and test. Appropriate use criteria have been developed to aid clinicians but are often not available in an easily accessible format. FOCUS (Formation of Optimal Cardiovascular Utilization Strategies), a Web-based community and quality improvement instrument, was developed to increase the feasibility of measuring and improving practice patterns based on the appropriate use criteria. The FOCUS instrument proposed to reduce inappropriate imaging by 15% in 1 year and by 50% within 3 years. Between April 2010 and December 2011, data were voluntarily collected through the FOCUS radionuclide imaging performance improvement module (PIM). Appropriateness rates were compared between phases of the PIM. For the 55 participating sites that had completed the PIM by December 2011, the proportion of inappropriate cases decreased from 10% to 5% (p < 0.0001). These preliminary data from initial participating sites suggest that through the use of a self-directed, quality improvement software and an interactive community, physicians may be able to significantly decrease the proportion of tests not meeting appropriate use criteria. Copyright 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.All authors: Allen J, Hendel R, Saifi S, Taylor AJFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2014-04-03
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Journal Article MedStar Authors Catalog Article 23643281 Available 23643281

Resource-sensitive and quality-centered imaging begins with the selection of the appropriate patient and test. Appropriate use criteria have been developed to aid clinicians but are often not available in an easily accessible format. FOCUS (Formation of Optimal Cardiovascular Utilization Strategies), a Web-based community and quality improvement instrument, was developed to increase the feasibility of measuring and improving practice patterns based on the appropriate use criteria. The FOCUS instrument proposed to reduce inappropriate imaging by 15% in 1 year and by 50% within 3 years. Between April 2010 and December 2011, data were voluntarily collected through the FOCUS radionuclide imaging performance improvement module (PIM). Appropriateness rates were compared between phases of the PIM. For the 55 participating sites that had completed the PIM by December 2011, the proportion of inappropriate cases decreased from 10% to 5% (p < 0.0001). These preliminary data from initial participating sites suggest that through the use of a self-directed, quality improvement software and an interactive community, physicians may be able to significantly decrease the proportion of tests not meeting appropriate use criteria. Copyright 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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