Quality Improvement
MedFocus Radiology Network has established a Quality Improvement Committee for developing criteria for the acquisition and interpretation of diagnostic studies and reporting formats for completeness and clarity. These standards are confirmed during retrospective review when outliers are placed in peer review.
The results of peer review and grievance programs are utilized in the medical chart review process, along with outcomes, in developing new standard criteria.
Primary Source Verification to NCQA standards is performed on all radiologists which includes confirmation of provider attendance and completion of medical school, internship and residency, and board certification status; verification of current license and DEA/CDS status; identification of sanctions against licensure in all 50 states, sanctions from hospital and medical groups or sanctions by Medicare or Medicaid; query by the National Practitioner Date Bank; etc.
Privileging, which is performed at the payors' request, identifies those radiologists who have had specific MRI training through fellowships, those facilities with high field strength magnets with the most up to date hardware and software and those with the best service. The results of the privileging process are utilized in rating the sites within a priority system which is used during scheduling with MRN's mapping software. The rating of the privileging process may modified by results from the grievance and outcome programs.
Centers of Excellence are utilized at the payors' request. Qualified MRI radiologists from Medical School Radiology Departments and/or privileged radiology groups are used for interpretation of MRIs performed at sites without privileged radiologists. The studies are either fed exed or transmitted by teleradiography.
Outcomes analysis is performed to determine the utilization patterns and diagnostic acuity of referring specialists and over-reading patterns of radiologists.
