Scott Cowsill, senior product manager of Diagnostic Solutions at Nuance and co-founder and chair of the Imaging e-Ordering Coalition, spoke with DOTmed about the clinical decision support industry's hopes for the CMS demonstration project. The Centers for Medicare and Medicaid Services (CMS) wants to see if clinical decision support can reduce unnecessary medical radiation exposure.

As reported previously in DOTmed, the two-year demonstration project will test whether the use of clinical decision support systems can improve quality of care, and reduce unnecessary radiation exposure and utilization through promoting appropriate ordering of advanced imaging services. In the project, participating physician practices will receive periodic feedback reports comparing their ordering patterns with those of their peers. The project will assess the effect of feedback reports on physicians' ordering behavior.

The Imaging e-Ordering Coalition was launched in June of 2009 to promote Health Information Technology-enabled clinical decision support in ensuring patients receive the most medically appropriate diagnostic imaging test for their specific condition. The Coalition has since grown in membership to include more than 10 organizations, vendors, academic institutions, and specialty societies including the American College of Radiology, Center for Diagnostic Imaging, Nuance, GE Healthcare, and several imaging service providers and electronic support tool vendors. Nuance, of Burlington, Mass., has a product, the RadPort™ application, for guiding appropriate high-tech diagnostic image order entry.

Both Nuance and the Coalition have strong interest in the demo project. Cowsill explained that the Coalition's goal is to have the best of the best as the experts in the industry, for any questions regarding managing high-tech diagnostic imaging and clinical decision support. In addition, its mission is to educate the federal government and the private sector that electronic clinical decision support (e-CDS) for high-tech imaging is as effective, or more effective, than the radiation benefit management (RBM) alternative. (RBMs are third-party services that handle the calls clinicians must make in some cases to have high-tech diagnostic tests approved.)

Nuance and its competitors have specific products in the marketplace and several competitors are members of the Coalition. Therefore, both the companies and the Coalition are invested in health IT and have significant interest in seeing the demonstration project succeed.

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