Virginia Mason Practices in the Appropriate Clinical Protocol Range for MRI of Spine Use in Diagnostics for Low Back Pain

  • Cave Consulting Group
  • CCGroup
  • Virginia Mason Practices in the Appropriate Clinical Protocol Range for MRI of Spine Use in Diagnostics for Low Back Pain
April 19, 2013
lowbackpain

Virginia Mason Practices in the Appropriate Clinical Protocol Range for MRI of Spine Use in Diagnostics for Low Back Pain

SAN MATEO, Calif.–()–CCGroup is pleased to announce that Virginia Mason Medical Center (Virginia Mason) in Seattle, Wash. continues to practice in the appropriate Clinical MedMarker™ Protocol Range for utilizing MRI of Spine in diagnostics for routine, non-complicated low back pain (LBP) patient episodes-of-care.

This news is not surprising to Robert Mecklenburg, MD, Medical Director of the Center for Healthcare Solutions at Virginia Mason. “In 2005, the medical center pursued efficiency in its spine clinic by adopting systems engineering methods of Toyota Motor Corp. As we published in the Wall Street Journal in 2007, back pain patients now follow a more standardized path. They have an initial combined visit with a physical therapist and a doctor,” Dr. Mecklenburg said. “We developed evidence-based decision rules and embedded them in the scheduling process for radiology. If the provider could not document the evidence-based indication for the imaging study on the scheduling screen, then the test could not be ordered.” He continued, “Within a year, the imaging rate of MRI of Spine decreased 23% across the enterprise.”

MRI of Spine is the key diagnostic service related to orthopedists’ efficiency score in treating non-complicated LBP. Therefore, MRI of Spine is the MedMarker™ (or correlated service) in treating non-complicated LBP.

“CCGroup is the only company in the market that has developed MedMarkers™ for all prevalent medical conditions treated by each physician specialty type,” stated Douglas G. Cave, Ph.D., President of CCGroup. “MedMarkers™ are process of care quality measures, well-defined in clinical guidelines. However, they also are the key services and procedures most associated with cost-of-care in treating a medical condition such as LBP.”

John Rootenberg, M.D., SVP of Clinical Strategy for CCGroup, asserted, “CCGroup is the first and only company to develop appropriate Clinical MedMarker™ Protocol Ranges for common medical conditions. These ranges were developed by presenting the CCGroup National Comparative MedMarker™ Database results to the CCGroup National Specialist Panels. Specialists on a CCGroup National Specialist Panel need to have an academic appointment or affiliation at a targeted, well-respected U.S. medical school.”

He continued, “Each specialist on a CCGroup National Specialist Panel was asked to review medical condition-specific MedMarker™ results. Then, they defined the ‘percentage of patients’ where a MedMarker™ service of interest is likely clinically warranted. The specialists also were instructed to ensure the percentage of patients selected was not too low to represent underutilization of care.”

Based on the CCGroup National Specialist Panel results, an appropriate Clinical MedMarker™ Protocol Range was selected for each medical condition. For example, the acceptable Clinical MedMarker™ Protocol Range for orthopedists is no more than 0-to-20 out of every 100 routine LBP episodes with an MRI of Spine. Yet, practice variation studies show many orthopedic groups with MRI of Spine rates significantly higher than the appropriate Clinical MedMarker™ Protocol Range.

However, Virginia Mason continues to practice in the appropriate Clinical MedMarker™ Protocol Range for utilizing MRI of Spine in diagnostics for LBP. The Virginia Mason result is nine (9) patient episodes out of every 100 routine LBP patient episodes. “Virginia Mason receives top marks for clinical appropriateness of MRI of Spine,” stated Dr. Cave.

CCGroup will continue to work with healthcare clients to develop their acceptable Clinical MedMarker™ Protocol Ranges. These ranges are needed to identify and improve unwarranted variations in physician practice patterns and reduce rising costs, while improving quality of care. The Clinical MedMarker™ Protocol Ranges support healthcare clients’ value-based contracting, accountable care work efforts, and patient centered medical home activities.

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