Economy causing more MRI accidents?

Insurers, the organizations that pay for the vast majority of MRI exams in the US, have been incrementally cutting the prices that they’ll pay hospitals and imaging centers for MRI studies. To a degree, this has been in response to ever-growing MRI scan volumes, which have lead to some economies of scale. A few years ago, Medicare / Medicaid switched from taking incremental nibbles off of the reimbursement rate, to lopping off a huge chunk with the budgetary equivalent of a machete, called the Deficit Reduction Act (DRA). Many commercial insurers followed suit.

The accumulated reimbursement cuts from the whole cadre of insurers has taken years following the initial enactment of the DRA to reach its full effect, just in time for the bottom to drop out of the broader economy. Now MRI providers are not only getting paid less for each exam, with many patients having to fork-over a 20% copay for the cost of their MRI exam, the number of patients walking in the door has also dropped.

A trend that began with the enactment of the DRA a few years ago may actually be building momentum, namely cutting staff, or cutting staff qualifications, to reduce the operating expenses of an MRI operation. Source

 

These reductions may be the worst thing for any hospital or outpatient center. Your greatest asset is The MRI technologist. The technologist understands MRI Safety at a level unparalleled to any one else in the diagnostic imaging environment. As the level of training decreases of staff the level of MRI safety accidents will continue to rise inversely proportionally. This is exactly why there has been a 277% rise in reported accidents.

This may seem a little over-simplified evaluation of a very complicated matter. However, the economy does correlate to the dramatic rise in MRI safety accidents. I can only put the pieces together. If cut backs are hurting health care at the patient level, where safety is concerned it is time to step in and make some drastic changes. Please let me know how you feel about this……

 

 

Dynamic Secretin-enhanced MR Cholangiopancreatography

Studies have shown that Secretin

Enhanced MRCP improves visual clarity

by sharpening images.

For Additional References

on S-MRCP, Please Visit

http://www.smrcp.com/SMRCP%20Images.pdf

Or call 1-877-272-4888

INTRODUCTION

Magnetic resonance (MR) cholangiopancreatography is a noninvasive technique for evaluation of the pancreatic ducts and biliary tree. The method has been available for more than a decade and is based on the use of heavily T2-weighted MR sequences to suppress the signal from most soft tissues and allow the stationary fluid in the ducts to be visualized. Use of a contrast agent is not necessary at MR cholangiopancreatography, and the imaging examination is often performed without it. However, we have found that the use of secretin, a hormone that stimulates pancreatic secretion, improves our ability to assess the pancreatic duct system. In this article, we discuss and illustrate the utility of secretin-enhanced MR cholangiopancreatography in the detection of various pancreatic diseases.  http://radiographics.rsna.org/content/26/3/665.full

Figure 5a. Complete pancreas divisum. (a)Presecretin MR image does not clearly depict the main pancreatic duct. (b) MR image obtained 5 minutes after secretin injection clearly shows the main duct in the body of the pancreas (white arrow) and the dorsal duct (arrowhead) in continuity with the main duct. Note that the main duct does not join with the distal common bile duct (black arrow), a finding that indicates complete pancreas divisum.(c) Corresponding ERCP image obtained after injection via the minor papilla helps confirm pancreas divisum and shows a santorinicele (arrow) at the minor papilla.

Figure 5b. Complete pancreas divisum. (a) Presecretin MR image does not clearly depict the main pancreatic duct. (b) MR image obtained 5 minutes after secretin injection clearly shows the main duct in the body of the pancreas (white arrow) and the dorsal duct (arrowhead) in continuity with the main duct. Note that the main duct does not join with the distal common bile duct (black arrow), a finding that indicates complete pancreas divisum.(c) Corresponding ERCP image obtained after injection via the minor papilla helps confirm pancreas divisum and shows a santorinicele (arrow) at the minor papilla.

figure 5c. Complete pancreas divisum. (a) Presecretin MR image does not clearly depict the main pancreatic duct. (b) MR image obtained 5 minutes after secretin injection clearly shows the main duct in the body of the pancreas (white arrow) and the dorsal duct (arrowhead) in continuity with the main duct. Note that the main duct does not join with the distal common bile duct (black arrow), a finding that indicates complete pancreas divisum.(c) Corresponding ERCP image obtained after injection via the minor papilla helps confirm pancreas divisum and shows a santorinicele (arrow) at the minor papilla.

figure a

figure b

figure c

CONCLUSIONS

Secretin is a safe, albeit costly, agent that improves visualization of the main and side pancreatic ducts in normal and pathologic states during MR cholangiopancreatography. Dynamic MR cholangiopancreatography after secretin administration also provides valuable information about the secretory reserve capacity of the pancreas. Yet, a lack of awareness of the value of secretin-enhanced MR cholangiopancreatography among radiologists and referring clinicians has limited the use of this technique.  http://radiographics.rsna.org/content/26/3/665.full

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Diffusion-Weighted MR Imaging: Applications in the Body

D.-M. Koh, Harriet C. Thoeny “Diffusion-Weig

hted MR Imaging: Applications in the Body”
Springer | English | 2009-12-03 | ISBN3540785752 | 299 pages | PDF | 87,6 MB

BOOK DESCRIPTION

The clinical applications of diffusion-weighted MR imaging (DW-MRI) in the body are rapidly evolving. This volume highlights state-of-the-art techniques for performing DW-MRI measurement in the body and addresses important practical issues. Key points are highlighted that will help radiologists and technologists to acquire high-quality images for disease assessment and to adapt the technique to their own clinical practice or research. The major clinical applications of DW-MRI in the body, both oncological and non-oncological, are extensively illustrated, providing readers with a broad insight into the growing uses of the technique. The final section addresses future developments, considering the potential importance of the technique in relation to drug development and the ways in which DW-MRI might be combined with other functional imaging techniques to further improve disease assessment.

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MRI scans on Electronic devices happen all to often

FOR IMMEDIATE RELEASE

Washington, DC — Today, the National Council on Aging (NCOA) released the results of a national survey of older adults, caregivers, and health care providers evaluating knowledge and awareness of medical imaging safety. The survey, which focused largely on electronic implantable device patients and their caregivers, reveals that communication about the safety of medical imaging for patients with these devices is often inadequate.

“The survey clarifies that older adults with electronic implantable devices such as pacemakers need better information on the benefits and risks of medical imaging,” said Stuart Spector, Senior Vice President of the NCOA. “Our aim is to highlight the results of this survey to increase awareness and facilitate a more productive dialogue between patients, caregivers, and health care providers.”

Editors of the New England Journal of Medicine named medical imaging as one of 11 developments that changed the face of clinical medicine during the last millennium. Medical imaging plays a critical role in early disease detection, diagnosis, and treatment. Yet, despite the importance of medical imaging, the NCOA survey found that over 90% of physicians agreed that magnetic resonance imaging (MRI) is contraindicated and may be risky for patients with certain electronic implantable devices, such as pacemakers, and very few will order MRIs for these patients.

“Patients and doctors have always valued choice and safety. Patients want their doctors to have the right imaging tools such as MRI available to them for the doctor to make the correct diagnosis,” said Dr. J. Rod Gimbel. “However, patients with pacemakers who might have an MRI should understand the potential risks. For many patients where MRI would be the right choice, that choice is complicated by the presence of their pacemaker.”

After the age of 65, a person’s chance of needing medical imaging doubles, and between 50% and 75% of patients with electronic implantable devices will likely need medical imaging over their device’s lifetime.

Confusion Exists Over Risks

The survey, made possible by a grant from Medtronic, found that nearly a third of patients and more than half of caregivers did not recall being informed that they or the person they care for might not be eligible for some forms of medical imaging at the time the device was implanted. The survey also found that three in 10 electronic implantable device patients have had an MRI despite the risks, and of this group nearly 20% reported experiencing problems with their device afterwards.

Physicians Agree More Education is Needed

In addition, the survey evaluated health care provider perceptions and use of guidelines from the American College of Cardiology (ACC), the American College of Radiology (ACR), and American Heart Association (AHA) for MRI use in patients with electronic implantable devices. The physicians reported using clinical guidelines often, referring to the ACC, ACR, and AHA guidelines in near equal numbers for medical imaging. Nearly all health care providers surveyed (98%) support more education on medical imaging and electronic implantable devices to help ensure awareness of critical guidelines, including that electronic implantable devices should not be regarded as safe for medical imaging simply because they are labeled as modern or recently manufactured.

This survey has prompted NCOA to host a series of community events across the country. At the events, experts will share the results of the survey and provide information about medical imaging safety, particularly for patients with electronic implantable devices. These free events will be held at community centers across the country beginning in Orlando, FL in February–American Heart Health Month. For more information on the Orlando event, please call Ben White at 407-254-9078.

See more information on these events.

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Research Methodology
Penn Schoen Berland (PSB) conducted 1,077 online interviews with 652 older adults, 273 caregivers and 152 physicians from November 19-30, 2009. Overall, margin of error for patients and caregivers is +/-3.22% and +/-7.95% for physicians.

About NCOA
The National Council on Aging is a nonprofit service and advocacy organization headquartered in Washington, DC. NCOA is a national voice for older Americans–especially those who are vulnerable and disadvantaged–and the community organizations that serve them. It brings together nonprofit organizations, businesses, and government to develop creative solutions that improve the lives of all older adults. NCOA works with thousands of organizations across the country to help older adults find jobs and benefits, improve their health, live independently, and remain active in their communities. For more information, visitwww.ncoa.org

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ipad follow up

I work in MRI at a small hospital but Imaging is a high priority. The Apple Ipad is a low cost easy to use system for Doctors to use to review important medical data and images from home or at the office before they see the patients they have been consulted on. This will revolutionize medicine as we know it.  Faster discharge planning and easier access to vital knowledge by doctors will make medicine more streamline than ever. It is small and portable anyone can operate it.  We will see this becoming available to hospitals soon.

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