Did you know that not all magnetic resonance imaging (MRI) exams are of equal quality? Walmart officials know this, and they are concerned that poor exams given to their employees are costing the company money. Because people with multiple sclerosis are likely to have several MRIs over the course of our disease, we should also be concerned, because poor exams could be costing us our health.
According to Kaiser Health News, Walmart officials have discovered that about half of the company’s workers who had back surgery over the past few years actually didn’t need it. The reason for the misdiagnoses: errors in their CT scans and MRIs. So Walmart, whose health plans cover more than a million people in the U.S., is trying to do something about it.
Company officials identified 800 imaging centers across the U.S. that they consider “high quality.” When a Walmart employee needs an MRI or a CT scan, they are encouraged to use one of the high-quality centers, even though the scans may cost more than they do elsewhere. In the end, company officials believe that by improving the quality of the diagnostic tests, Walmart will reduce unnecessary treatments and save money. If an employee decides not to use one of the 800 selected imaging centers, they will be required to pay a higher cost-share for the test.
‘A lot’ of imaging errors
According to KHN, “studies show a 3% to 5% error rate each workday in a typical radiology practice, but some academic research has found mistakes on advanced images such as CT scans and MRIs can reach up to 30% of diagnoses.”
“There’s no question that there are a lot of errors that occur,” Dr. Vijay Rao, chairwoman of radiology at the Thomas Jefferson University Hospital in Philadelphia, told KHN. Rao said many causes of the errors exist, including technicians who misposition patients in the machine, inexperienced radiologists reading the scans, or radiologists who are rushed or tired.
Walmart hired Covera Health, a health analytics company, to locate the 800 preferred imaging centers. Covera uses independent radiologists to review doctors, equipment, and imaging protocols at centers. It also calculates an error rate for each facility.
But we don’t see the error rates
Most of us probably don’t think about the quality of our MRIs. Even if we did, there’s probably little we could do to determine which imaging centers provide the most accurate results. The KHN story said that the American College of Radiology has an accreditation program, but it doesn’t evaluate diagnostic quality. Though the centers themselves review the reports their radiologists write, these reviews aren’t available to patients.
As important as MRI results are to multiple sclerosis diagnosis and treatment, it would be extremely useful to know the quality of the facilities providing imaging services. Bravo to Walmart for demanding quality.
It would seem that improving quality care while saving money is a win-win. So, why don’t more employers and insurance plans follow Walmart’s lead and do the same?
You’re invited to visit my personal blog at www.themewire.com.
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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.
I wish we had access to this list.
So now we’re informed that some MRI equipment, scans, and centers are better than others, but we have no way of knowing what those are or how to identify them…?
Polly,
You DO have a way of knowing the equipment being used. Just call the place where you intend to have an MRI and ask.
Ed
With MS, look for a place that has a high powered MRI machine. Most are 1-1.5 Tesla; 3 Tesla units give much better image detail and are being used more frequently. The link below features a 10 Tesla unit and MRI brain scans are stunning. It’s also important to try to use the same place and MRI scanner, so machine bias is taken out of the equation. I have had 1 Tesla scans and 3 Tesla scans and get markedly different results in terms of lesion load. Also ask to have a radiologist who is very experienced in reading MS patients scans and ideally, the same radiologist reading scans every time, though this is difficult to do. Some neuros are not that good at reading MRIs and rely on the radiologist report.
1. 1.5 Tesla scanners are the current gold standard. ( A 3Tesla mri scanner also increases the cost of Imaging and is overkill).
2. Many referring Doctors do not care or don’t understand what is the quality of the MRI machine or images. It’s worse if they have a vested interest in the imaging center because they wouldn’t even care about the reader of the images. (It’s important to know if there is a vested interest in the imaging center by your doctor which contributes to over utilization and increase in healthcare costs ).
As a radiologist, I suggest looking for a place that has a radiologist on site that overlooks the protocols, overlooks the technicians, is involved with the patients and day-to-day operations – not leaving the center at the discretion of a technician or business manager to do the quality control day in and day out.
The radiologists should put a face to Radiology and be willing to call patients directly if urgent findings too or go over exams if patient requests it.
That’s my idea of a quality imaging center to go to!
That’s my two cents .
Signed,
Radiologist
Thanks for sharing your thoughts, doctor.
That’s excellent information that I’m sure will benefit all who read it. (I’ll certainly keep all of that in mind when scheduling my next scan).
Ed