Robert W. Westergan, MD, an orthopaedic surgeon from Vermont, is the new president of the Intersocietal Commission for the Accreditation of Magnetic Resonance Laboratories (ICAMRL). Dr. Westergan is the third president in ICAMRL’s 9-year history and the first orthopaedic surgeon to hold this influential position.

AAOS Now

Published 10/1/2009

Orthopaedic surgeon takes the helm at ICAMRL

Encourages accreditation, support for quality diagnostic imaging

Robert W. Westergan, MD

“As a major diagnostic imaging method for the evaluation of many musculoskeletal disorders, magnetic resonance imaging (MRI) must be performed for the appropriate indications, and interpreted accurately and consistently, in order to demonstrate value in the patient’s overall episode of care,” said Dr. Westergan at the outset of his presidency.

Recognizing this concern, ICAMRL offers an accreditation program that evaluates the quality of the critical elements of a magnetic resonance laboratory. The peer-review process provides a mechanism for facilities performing magnetic resonance—in private office settings, outpatient imaging centers, and hospitals—to evaluate and demonstrate quality in imaging, quality in interpretation, quality in reporting, and most significantly, the overall quality of patient care that they provide.

“I encourage my fellow orthopaedic surgeon colleagues who are involved with the performance and/or interpretation of MRI studies to explore the benefits of ICAMRL accreditation and consider participation,” said Dr. Westergan.

“We all have a responsibility to pursue and document quality patient care. Diagnostic imaging is under the microscope of both Medicare and private payors. ICAMRL provides our specialty with an ideal method for evaluating our performance and interpretation of MRI procedures,” he added.

ICAMRL accreditation
The foundation of the accreditation process, The ICAMRL Standards, can be reviewed and downloaded from the
ICAMRL Web site. The all-inclusive document covers each type of accreditation offered by the ICAMRL (body, cardiovascular, musculoskeletal, and neurological) and defines the key components of quality MRI including indications, techniques, and components of examination performance, procedure volumes, and quality assurance—both technical and interpretive.

In addition, Magnetic Resonance Imaging Operations—Organization, another standards document, details the administrative and operational functions necessary to support an MRI lab, including personnel (medical and technical), supervision, support services, physical facilities, examination interpretation, report and records, safety and patient confidentiality, and quality assurance (including a requirement for a quality assurance committee to oversee system and laboratory performance).

The user-friendly ICAMRL online accreditation allows for easy application access and submission. All labs seeking accreditation must purchase access to the ICAMRL online accreditation application for $200. Laboratories are required to electronically upload all supporting documentation and attachments, with the exception of the case studies, and should allow several weeks to compile, refine, and organize the required protocols, reports, and supplemental materials in preparation for application submission.

The IAC
ICAMRL is a member of the Intersocietal Accreditation Commission (IAC), a recognized contributor to continuous improvements in health care. Other divisions of the IAC include the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL), the Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL), and the Intersocietal Commission for the Accreditation of Computed Tomography Laboratories (ICACTL).

To date, the IAC accrediting bodies have granted accreditation to more than 8,000 laboratory sites throughout the United States, Canada, and Puerto Rico. Each of the five IAC accrediting divisions offers a comprehensive, peer-review accreditation program for its respective area of diagnostic testing and is recognized for providing a mechanism through which laboratories can demonstrate their commitment to quality care. The accreditation granted by the IAC signifies that a laboratory has been reviewed by an independent agency and that the applicant facility was found to be in substantial compliance with objective standards of quality.

To learn more about ICAMRL accreditation, visit the ICAMRL Web site, or call the IAC office at 800-838-2110. Additional contact information is provided online at http://www.intersocietal.org

Editor’s Note: Under the Medicare Improvements for Patients and Providers Act of 2008, providers of advanced diagnostic imaging services—inclusive of nuclear medicine, magnetic resonance, computed tomography, and positron emission tomography—are required to obtain accreditation by 2012, as a condition for reimbursement. The Secretary of Health and Human Services will announce the designated accreditation organizations in 2010. The Intersocietal Commission for the Accreditation of Magnetic Resonance Laboratories was established to provide the multiple specialties using MRIwith a pathway to demonstrate quality.

Voluntary MR accreditation: Why orthopaedic surgeons should take note
Now more than ever, MRI providers need to demonstrate their commitment to quality—to insurance carriers, to referring physicians, and to patients.

  • ICAMRL accreditation enables orthopaedic surgeons to demonstrate their commitment to quality magnetic resonance studies by participating in a program developed with input from multiple specialties, including those representing the orthopaedic surgery community. The AAOS is among the eight sponsoring organizations and has two representatives on the ICAMRL board of directors: Robert W. Westergan, MD, and A. Louis Mariorenzi, MD.
  • The ICAMRL program provides an opportunity for laboratories using extremity-only magnets to apply for accreditation. Accreditation is offered in the separately defined areas of body (pelvis, abdomen, chest and/or breast), cardiovascular, musculoskeletal (including extremity), and neurological. Laboratories can apply in any or all of these areas, depending on the types and numbers of procedures they perform.

In addition to several regional reimbursement policies, the following published policies with national coverage are worth noting:

  1. Effective during the fourth quarter of 2009, UnitedHealthcare will require outpatient imaging sites and providers who bill on a CMS/HICF 1500 or its electronic equivalent, and perform any of the following procedures—computed tomography (CT), MRI, positron emission tomography (PET), nuclear medicine, nuclear cardiology, and echocardiography—to have completed and submitted an application to obtain accreditation as a condition of eligibility for reimbursement. Accreditation applies to global and technical service claims.
  2. The Medicare Improvements for Patients Providers Act of 2008 requires providers of advanced diagnostic imaging services—inclusive of nuclear medicine, MR, CT, and PET—to obtain accreditation by 2012, as a condition for reimbursement.

In addition to potential reimbursement benefits, accreditation is an ideal mechanism for a laboratory to voluntarily demonstrate its commitment to quality patient care. The ICAMRL encourages accredited laboratories to proudly promote their achievement to peers, referring physicians, and patients by including the accredited laboratory logo on reports, through articles in community and hospital newsletters, facility brochures, and other internally generated promotional mechanisms.