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Accreditation requirements spur physicists to action

Radiology Administrator's Compliance and Reimbursement Insider, June 1, 2007

The phones at West Physics Consulting started ringing off the hook as soon as UnitedHealthcare (UHc) an-nounced its new accreditation requirement.

In order to receive UHc payment after March 1, 2008, affiliated independent diagnostic testing facilities and physician offices operating imaging equipment need either American College of Radiology (ACR) or Inter-societal Accreditation Commission (IAC) accreditation.

With more than 10,000 facilities slated for accreditation, and fewer than 100 physicists in the country able to perform the necessary equipment tests associated with ACR accreditation requirements, W. Geoffrey West, M.Eng., DABR, CHP, president and CEO of West Physics in Atlanta, expects an assessment gridlock.

"You really have to feel for these facilities," West says. "They're caught in a difficult situation, and many don't even know about the new requirements."

In fact, the IAC expedited its new CT accreditation requirements posting them on its Web site in April.

CT specifics add to accreditation traffic concerns

West estimates that 65% of MRI units in the United States obtained accreditation already.

However, only 15% of CT units have received accreditation for that modality, he estimates. Also, facilities with multiple modalities (e.g., CT and MRI, or CT and PET) need multiple accreditations, which could add to the assessment bottleneck.

CT scans represent the greatest accreditation challenge from the physicist's perspective, West says. "It's very meticulous. Regions of interest must be laid out properly. It takes hours and hours of prep work." Multi-detector CT scanners challenge physicists further, he says. "You have to know how the detector is configured. You can't just go through a simple procedure to do the accreditation."

Increased assessment equals increased business

Typically, medical physicists operate on a "mom-and-pop" business model, with two or three physicists working in a given geographic area. Because hospitals often employ their own physicists, those staff members often moonlight their expertise to independent diagnostic imaging facilities and physician offices.

However, with UHc's new accreditation requirements, there's an increased demand for specialized physicists' knowledge. "It's really grown from a fragmented industry with limited expertise requirements to an ex-tremely complicated analytical field," says West. "Most physicists are competent in x-ray surveys. That's what they do every day."

But fewer physicists can perform the necessary analysis on the newer, more complicated machines.

Finding the right physicist takes time

Freestanding facilities and physician offices with imaging equipment may not have a medical physicist on staff. In fact, says West, although most large hospitals do employ a medical physicist, it's an anomaly in the freestanding diagnostic imaging world. Unfortunately, consulting medical physicists can be hard to find. Internet searches will locate the more established firms but many firms rely exclusively on word-of-mouth marketing.

The important thing is to assess the physicist's experience and pass rate with accreditation on each modality and to compare educational credentials and board certifications (such as from the American Board of Radiology).

The practice of medical physics applies the principles and accepted protocols of physics to ensure the correct quality, quantity, and placement of radiation during the radiological procedure, according to the American As-sociation of Physicists in Medicine (www.aapm.org).

Medical physicists take care of equipment testing, device specification, and image quality assessment,as well as ensure that all the science behind imaging mechanics works the way it's supposed to.

Insider source:

W. Geoffrey West, M.Eng., DABR, CHP, president, West Physics Consulting, 4339 Oakdale Vinings Circle SE, Smyrna, GA 30080, 770/435-9186; info@westphysics.com.

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