This post was authored by Manuel D. Cerqueira, MD, FACC, chair of the ACC’s Imaging Council.

Over the past eight years the ACC has developed Appropriate Use Criteria (AUC) for several imaging modalities with the goal of helping physicians choose the right test for the right patient.  As explained in a previous blog post, at one point usage statistics for diagnostic imaging was shown to have the fastest growth among all medical services covered by Medicare. Although this statistic has since declined, there is still generally room for improvement.

The AUC were developed to review patterns of care and serve as a framework for assessing appropriateness of care. As the terms for AUC (appropriate, inappropriate and uncertain) continue to be misconstrued by the media and payers, it has become increasingly important to educate these audiences about the effectiveness of AUC and the associated quality improvement tools in improving cardiovascular patient care.

Over the past few years, the College has advocated for the use of AUC as an alternative to prior-authorization based on arbitrary criteria, RBMs or “slash-and-burn” payment cuts (a great example of these efforts is in Delaware, which you can read about in a previous blog post here).  As payer’s use of AUC to determine payment becomes more prevalent, we have seen a deeper, more trusting relationships develop between insurance companies and physicians. The imaging community must continue to be stewards of AUC in order to maintain this level of credibility.

In addition, through Imaging in FOCUS, the College’s web-based Performance Improvement Module (PIM) based on ACC-developed AUC, physicians can track their appropriateness rates for radionuclide imaging (read more about FOCUS in a blog post here). The Imaging Council fully supports the use of FOCUS as a quality improvement tool in physician practices, hospitals and health plans, and we have identified promoting a PIM for echocardiography as a top priority for 2012. We urge other physicians and payers to adopt this tool as it provides real-time AUC benefit/risk calculations for individual patients and allows physicians and other organizations to track AUC patterns and exceptions over time.

The Imaging Council and Membership Section of the ACC will continue to represent the cardiovascular imaging community and work with ACC leadership to promote collaboration on issues facing cardiovascular specialists using imaging technologies to provide optimal patient care.

While an eye remains on the cardiovascular imaging community, it is my hope that through use of the AUC and these quality improvement tools, we choose the right test for the right patient, ultimately reducing waste in the health care system and improving care.

This post is from a special AUC series on the blog focusing on the “basics” of what the AUC are, how to use them now, how the AUC can/will be used in the future, as well as the various ACC resources and tools available. Click here to read more.

For more information about the Imaging Council and Membership Section of the ACC and how to get involved, visit www.cardiosource.org/Imaging.