Clinical Decision Support (CDS) for imaging, provides advice to physicians who order medical imaging, using guidelines that consider scientific evidence and best practices. These guidelines are often referred to as Appropriate Use Criteria or AUC. Use of AUCs can reduce unnecessary imaging and improve overall diagnostic approaches leading to better patient care.
The use of CDS when ordering imaging for Medicare patients has been mandated by Congress as part of the Protecting Access to Medicare Act of 2014 (PAMA 2014). This requirement will take effect on January 1, 2022.
The Centers for Medicare & Medicaid Services (CMS) have designated specific organizations that are able to create these guidelines. Based on the recognition of Weill Cornell’s experience with clinical decision support and the expertise of our Physician-Researchers, Weill Cornell has been qualified to develop AUCs.
Guidelines for the CMS AUC program may be found on this website with information on the scientific studies that were used to determine what diagnostic imaging, if any, is recommended for the medical condition(s) of concern when imaging is ordered. This website includes members of the teams who were part of the creation process. Each member of the team is required to list any conflict of interest they may have in relation to the guidelines which they worked on.
For the CMS AUC program, Weill Cornell has created criteria for imaging when patients have one or more of the following:
CDS delivers advice through the systems that your provider(s) use to order imaging (radiology and cardiology) examinations. CDS helps choose the best test to get the information needed.
AUCs are the guidelines that CDS uses when providing advice for imaging studies. AUCs are based on scientific evidence and best practices and provide recommendations based on multiple factors including why a patient may need imaging, other known medical problems, prior imaging examinations that have been done, age of the patient, medical risk scores and many others.
In 2014, Congress passed the Protecting Access to Medicare Act of 2014 (PAMA) which among other things mandates the use of CDS/AUC for Medicare patients with orders for certain types of imaging (e.g. Computed Tomography (CT), Magnetic Resonance Imaging (MRI), etc.). This will begin in 2022. CMS has provided guidance on what specific clinical conditions need to be covered. More information of the CMS AUC program may be found at:
The CMS AUC program qualifies certain organizations that have the required expertise and oversight to review the scientific literature and create guidelines based on the available evidence.
Weill Cornell has over a decade of experience using CDS to assist in providing the most appropriate imaging care. With our expert physicians and leading research teams, Weill Cornell has created criteria that, based on available evidence, allows us to provide the highest quality, safest, and most state-of-the-art diagnostic imaging available.
Others across the country have recognized the value of these criteria and have adopted the Weill Cornell AUC into their practices.
It is important to remember that even criteria that use many factors may not apply to every patient. They are meant to helpful for providers who order imaging, but do not replace the clinical knowledge and experience of your providers.
In our experience, most physicians order the most appropriate imaging almost all the time. They learn to do so through years of training and experience. If you have any questions, you should ask your provider about why they have ordered a specific examination.
Even with CDS you or your provider may still have questions on the most appropriate imaging examination(s). Providers and patients are encouraged to reach out to our practice through our radiology consultation service (RCS) at 646-962-2273 or radconsult@med.cornell.edu
