ACR introduces modular approach for its MRI accreditation program

The American College of Radiology has redesigned its MR imaging accreditation program to address six clinical subspecialties served by the modality.

The new configuration to be introduced in 2008 will reorganize the 10-year-old program into six modules. The modules will be designed for angiography and body, cardiac, head, musculoskeletal, and spine imaging. Breast MRI was excluded. It will be integrated into the ACR's breast imaging accreditation programs.

Current MRI accreditation addresses the general quality concerns relevant to whole-body MR equipment. The modular MRI approach under development takes into consideration clinically focused practices and facilities with multiple units that each specialize in certain aspects of imaging, said Theresa Branham, the ACR's program manager for MRI and CT accreditation.

Modular MRI accreditation will allow facilities to apply for accreditation based on their use of a particular scanner or scanners. Previously accredited MR facilities will go through the new process as they renew their accreditation, Branham said.

"This means that clinical practices will be able to choose examinations that fit their practice for each magnet, just as the CT accreditation program does. Patients can rest assured that a facility is accredited in the type of examinations that match the practice for that magnet," she said.

New accreditation programs also reflect the latest trend among third-party payers. Insurance companies such as United Healthcare are requesting MR accreditation for facilities nationwide as a requisite for reimbursement.

Application fees for modular accreditation will be announced when the programs are implemented. Under terms of the current program, the ACR charges $2400 for the first magnet at a facility, and $2300 for each additional magnet at the same facility. The ACR MR accreditation program was established in 1997. More than 5375 MR scanners are accredited or are seeking accreditation.

According to Branham, the new format will require submission of several routine and specialty clinical exams depending on the number of accreditation modules for which facilities apply. They can apply to be accredited for one or for all six modules. However, they must seek accreditation in all modules that fit their practice. The list of clinical routine and specialty examinations and the scoring criteria for each module will be announced in the first half of 2008.

MRI's expansion into multiple clinical areas and the need to maintain high-quality imaging standards drove the call for a new accreditation design, one that reflects the changes in modern MR clinical practices, Branham said.

The announcement brought about mixed reactions, said Dr. Douglas P. Beall, chief of musculoskeletal imaging at the University of Oklahoma Health Sciences Center in Oklahoma City. On one hand, the new accreditation process will help provide MR tests of reproducible quality across the nation. On the other, adhering to new regulations may require additional personnel and resources.

"You kind of wonder where that regulatory burden will stop," he said.

The overall quality of MRI has improved, according to Beall, but additional effort and expense will be needed to fulfill the new requirements. The challenge remains to establish a process that reproduces good quality across the board with as little red tape as possible to avoid overburdening the system.

"That's a very thin line to walk," Beall said.

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