@article{c084eb3cad1a45879f7d0f8309ef5c39,
title = "Expected Organizational Costs for Inserting Prevalence Information Into Lumbar Spine Imaging Reports",
abstract = "Background: Modifying physician behavior to more closely align with guideline-based care can be challenging. Few effective strategies resulting in appropriate spine-related health care have been reported. The Lumbar Imaging With Reporting of Epidemiology (LIRE) intervention did not result in reductions in spine care but did in opioid prescriptions written. Objectives: To estimate organizational resource needs and costs associated with implementing a pragmatic, decision support-type intervention that inserted age- and modality-matched prevalence information for common lumbar spine imaging findings, using site-based resource use data from the LIRE trial. Research design: Time and cost estimation associated with implementing the LIRE intervention in a health organization. Subjects: Providers and patients assessed in the LIRE trial. Measures: Expected personnel costs required to implement the LIRE intervention. Results: Annual salaries were converted to daily average per person costs, ranging from $400 to $2,200 per day (base case) for personnel (range: $300-$2,600). Estimated total average cost for implementing LIRE was $5,009 (range: $2,651-$12,020), including conducting pilot testing with providers. Costs associated with a small amount of time for a radiologist (6-12 hours) and imaging-ordering providers (1-8 hours each) account for approximately 75% of the estimated total cost. Conclusions: The process of implementing an intervention for lumbar spine imaging reports containing age- and modality-appropriate epidemiological benchmarks for common imaging findings required radiologists, imaging-ordering providers, information technology specialists, and limited testing and monitoring. The LIRE intervention seems to be a relatively low-cost, evidence-based, complementary tool that can be easily integrated into the reporting of spine imaging.",
keywords = "Costs, imaging, implementation, opioids, spine",
author = "Bresnahan, {Brian W.} and Jarvik, {Jeffrey G.} and Meier, {Eric N.} and James, {Kathryn T.} and Gold, {Laura S.} and Rundell, {Sean D.} and Turner, {Judith A.} and Pradeep Suri and Luetmer, {Patrick H.} and Friedly, {Janna L.} and Sherman, {Karen J.} and Heagerty, {Patrick J.} and Kallmes, {David F.} and Avins, {Andrew L.} and Griffith, {Brent D.} and Kessler, {Larry G.}",
note = "Funding Information: Dr Bresnahan, Dr Jarvik, Mr Meier, Ms James, Dr Gold, Dr Rundell, Dr Turner, Dr Suri, Dr Luetmer, Dr Friedly, Dr Sherman, Dr Heagerty, Dr Kallmes, Dr Avins, Dr Griffith, and Dr Kessler report grants from the United States of America's National Institutes of Health, during the conduct of the study. In addition, Dr Kallmes has a patent Spine Augmentation licensed to Kypheze Medical, LLC. Dr Jarvik reports Springer Publishing: royalties as a book co-editor; GE-Association of University Radiologists Radiology Research Academic Fellowship (GERRAF): Travel reimbursement for Faculty Board of Review; Wolters Kluwer/UpToDate: Royalties as a chapter author. Dr Friedly reports grants from United States of America Department of Defense, and other support from the American Academy of Physical Medicine and Rehabilitation, outside the submitted work. Dr. Bresnahan, Dr Jarvik, Mr Meier, Dr Gold, Dr Rundell, Dr Turner, Dr Suri, Dr Luetmer, Dr Friedly, Dr Sherman, Dr Heagerty, Dr Kallmes, Dr Griffith, and Dr Kessler are nonpartner, non–partnership track employees. Ms James was a nonpartner, non–partnership track employee, but is no longer an employee of the University of Washington, and is not an employee of a health care organization. Dr Avins is a partner in The Permanente Medical Group.This work was supported within the National Institutes of Health (NIH) Health Care Systems Research Collaboratory by the NIH Common Fund through cooperative agreement U24AT009676 from the Office of Strategic Coordination within the Office of the NIH Director and cooperative agreements UH2AT007766 and UH3AR066795 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). It was also supported by the University of Washington (UW) Clinical Learning, Evidence and Research Center for Musculoskeletal Disorders funded by NIH/NIAMS P30AR072572. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. We thank Dr Martin L. Gunn of the UW Department of Radiology for his expertise and guidance related to implementing radiology IT-based interventions. Renditions of our Supplemental Table 1 and Supplemental Table 2 were previously published in JAMA Network Open, 2020; 3(9):e2015713. https://doi.org/10.1001/jamanetworkopen.2020.15713, under the terms of the CC-BY license. Funding Information: This work was supported within the National Institutes of Health ( NIH ) Health Care Systems Research Collaboratory by the NIH Common Fund through cooperative agreement U24AT009676 from the Office of Strategic Coordination within the Office of the NIH Director and cooperative agreements UH2AT007766 and UH3AR066795 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). It was also supported by the University of Washington (UW) Clinical Learning, Evidence and Research Center for Musculoskeletal Disorders funded by NIH/NIAMS P30AR072572. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. We thank Dr Martin L. Gunn of the UW Department of Radiology for his expertise and guidance related to implementing radiology IT-based interventions. Renditions of our Supplemental Table 1 and Supplemental Table 2 were previously published in JAMA Network Open, 2020; 3(9):e2015713. https://doi.org/10.1001/jamanetworkopen.2020.15713 , under the terms of the CC-BY license. Funding Information: Dr Bresnahan, Dr Jarvik, Mr Meier, Ms James, Dr Gold, Dr Rundell, Dr Turner, Dr Suri, Dr Luetmer, Dr Friedly, Dr Sherman, Dr Heagerty, Dr Kallmes, Dr Avins, Dr Griffith, and Dr Kessler report grants from the United States of America's National Institutes of Health , during the conduct of the study. In addition, Dr Kallmes has a patent Spine Augmentation licensed to Kypheze Medical, LLC. Dr Jarvik reports Springer Publishing: royalties as a book co-editor; GE-Association of University Radiologists Radiology Research Academic Fellowship (GERRAF): Travel reimbursement for Faculty Board of Review; Wolters Kluwer/UpToDate: Royalties as a chapter author. Dr Friedly reports grants from United States of America Department of Defense , and other support from the American Academy of Physical Medicine and Rehabilitation , outside the submitted work. Dr. Bresnahan, Dr Jarvik, Mr Meier, Dr Gold, Dr Rundell, Dr Turner, Dr Suri, Dr Luetmer, Dr Friedly, Dr Sherman, Dr Heagerty, Dr Kallmes, Dr Griffith, and Dr Kessler are nonpartner, non–partnership track employees. Ms James was a nonpartner, non–partnership track employee, but is no longer an employee of the University of Washington , and is not an employee of a health care organization. Dr Avins is a partner in The Permanente Medical Group. Publisher Copyright: {\textcopyright} 2021",
year = "2021",
month = oct,
doi = "10.1016/j.jacr.2021.06.010",
language = "English (US)",
volume = "18",
pages = "1415--1422",
journal = "Journal of the American College of Radiology",
issn = "1546-1440",
publisher = "Elsevier BV",
number = "10",
}