By Garry Carneal, JD, RadSite President & CEO

The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a number of important regulations governing advanced diagnostic imaging (ADI) systems since the passage of the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”). In a recent blog, I noted how the current CMS requirements help protect Medicare beneficiaries who undergo ADI imaging, that is CT, MRI and PET/SPECT exams.

Although not specifically addressed in the current CMS regulations, older imaging equipment can be a marker for poor quality. In one study that RadSite co-sponsored with a national health plan several years ago, we looked at how the age of the ultrasound machine and the age of the last software upgrade could affect quality. To test the validity of this hypothesis, our researchers looked at regulations, peer-reviewed literature, expert opinion, and they completed an analysis by studying trends in the RadSite database.

The findings from a regulatory survey, literature review, and expert opinion support a correlation between the increasing age of an ultrasound machine and a decrease in quality of the ultrasound images. Although not rocket science, our study not surprisingly did find a correlation between the quality of the image and:  1) the age of the machine; and 2) the last software upgrade.

A two-part study was conducted and analyzed information both in the RadSite and the health plan’s databases. The first portion of the study examined the rate of repeat exams performed on ultrasound machines based on either the age of the machine or the age of last upgrade, whichever was most recent. The second analysis examined the same sample but focused only the age of the machine, and not any hardware or software upgrades. We used the frequency of repeat scans within a short period of time as the primary indicator of quality.

While the analysis data did not indicate a clear cut-off point that results in a large increase of repeat scans, there was a trend suggesting machines older than nine years have the highest repeat rates, which was detected in both parts of the study. The overall findings of this research paper do support the premise that the age of ultrasound equipment can impact the quality of the images. The study also highlights the need to track an array of related variables that might impact quality, such as the upgrades to the transducer probe, frequency of usage, and other key factors.

As part of our commitment to the highest quality standards, RadSite is moving forward on implementing minimum age and software upgraded requirements in the new MIPPA Accreditation Program Standards and Guide (version 3.0), released later this summer.

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