Measuring the Impact of Accreditation on Diagnostic Accuracy & Health Outcomes in Echocardiography
PI: Greg Ruhnke, Department of Medicine (Hospital Medicine)
Dates: 10/01/15 – 9/30/17
Funder: Intersocietal Accreditation Commission
Description: There has recently been a great deal of high-profile controversy about the cost and value of physician certification. Although such certification is distinct from imaging facility accreditation, there are certain analogies in the goal of these processes. As payers increasingly require accreditation, greater interest has arisen in demonstrating the effects of such accreditation on imaging quality and health. For example, the Medicare Improvements for Patients and Providers Act (MIPPA) created a requirement for accreditation of outpatient providers of advanced diagnostic imaging. We propose to create a framework for future rigorous research to demonstrate the impact of accreditation on diagnostic accuracy, maximizing the ability for causal inference, and estimate its cost-effectiveness. Since the Intersocietal Accreditation Commission (IAC) is the only organization that accredits echocardiography laboratories, this is a unique opportunity to observe quality across all facilities seeking accreditation at multiple points in time. This three-part proposal seeks to: (1) comprehensively review accreditation processes to identify observational and experimental research designs that would allow for a rigorous evaluation of its costs and benefits across heterogeneous imaging modalities; (2) using echocardiography as a case example, measure the change in quality of reports submitted to IAC after delayed accreditation and a period of accreditation, compared to those submitted at the initial accreditation application, and whether these differences vary by the characteristics of the imaging facility; (3) based on the information gained in project 2, create a cost-effectiveness model to estimate the value in both health and monetary terms of diagnostic error reductions associated with the accreditation process for echocardiography.