From the September 2011 issue of HealthCare Business News magazine
By: Dominique Delbeke, MD, PhD and Michael M. Graham, MD, PhD
This report originally appeared in the September 2011 issue of DOTmed Business News
The passage of the Patient Protection and Affordable Care Act in 2010 cast a new light on comparative effectiveness research (CER) for the medical profession. In order for medical procedures to continue to be reimbursed by the Centers for Medicare and Medicaid Services, their effectiveness in improving patient outcomes must be proven through research.
While this new paradigm has many merits, it has posed some problems for the molecular imaging community. How do you prove a molecular imaging scan is directly correlated to a successful patient outcome? Certainly, medical professionals would agree that imaging plays an important role in determining the course of treatment, but the struggle remains in how to quantitatively prove this.
The Society of Nuclear Medicine firmly believes that molecular imaging is advantageous to patients with a wide variety of illnesses, including heart disease, cancer and brain diseases.
SNM organized a conference on the topic in July of 2010, sponsored by the Agency for Healthcare Research and Quality and is planning for additional conferences. These meetings are directed at developing strategies to convincingly show that molecular imaging studies are effective in improving clinical outcomes.
At the July meeting, SNM drafted a strategic plan to address comparative effectiveness research for molecular imaging and has since begun to implement it. Specifically, SNM will take a leadership role in education about CER, identification of evidence gaps, communication and partnerships with stakeholder organizations, and development of evidence-based guidelines—including quality measurements—for nuclear medicine and molecular imaging.
SNM has made some more immediate progress regarding some of the areas identified above by establishing a senior-level, diversely experienced Executive Steering Committee to assist with creating a CER strategic direction and to facilitate communication and potential partnerships with other relevant professional societies engaged in CER activities.
SNM and individual investigators have also maintained the momentum generated by the July 2010 conference by arranging continuing education sessions, presentations and/or workshops in CER at SNM-sponsored events during 2011.
SNM is also now working with the Center for Medical Technology Policy to organize a symposium with the intent of achieving a shared understanding about the design of CER studies in nuclear medicine, across a range of relevant clinical professionals, researchers, payers, patients/consumers, product developers, regulators and others. In addition, the symposium will seek to develop one or more models for implementation of studies and will identify one research project as a high priority to design and implement based on the agreed upon method. This workshop will be held in early spring 2012 and is titled, “Design and Implementation of Comparative Effectiveness Research for Studies of Nuclear Medicine Imaging in Oncology.”
Without adequate reimbursement for imaging procedures conducted in hospitals or medical centers, care for patients may be negatively affected. By working to become part of the comparative effectiveness research model, SNM will show that molecular imaging is a critical part of a treatment plan that ultimately results in positive results for patients.
Dominique Delbeke, MD, PhD is director of nuclear medicine and positron emission tomography in the Department of Radiology and Radiological Sciences at Vanderbilt University in Nashville, Tenn. She is immediate past president of the Society of Nuclear Medicine.
Michael Graham MD, PhD is director of nuclear medicine in the Department of Radiology at University of Iowa. He is past president of the Society of Nuclear Medicine and co-chair of the SNM Comparative Effectiveness Research Program.