It’s Come To This: Trading MRI Safety For Reimbursement Support

If you’ve ever been on an email mailing list for the ACR, then you’ve probably received a few of these in the last few months… emails imploring you to contact your Senators and Representatives to urge them to support the Diagnostic Imaging Services Access Protection Act (HR 3269). So far I’ve received three or four of them, and for the ones I’d received previously, I replied, agreeing to contact my elected officials on their behalf, but on one condition…

ACR request to lobby federal elected officials

Email to Me From ACR

My Faustian bargain was this, I will throw my support enthusiastically behind HR 3269 if the ACR will simply identify a concrete timeline and performance objectives for MRI safety for their MR Accreditation program.

This should be very simple for the organization that has published the industry standard MRI safety document three (soon to be four) times over the last 10 years…

This should be simple for an organization that publicly stated that they would be doing exactly this three years ago at the AHRA annual meeting…

This should be simple for an imaging accrediting organization whose self-professed reason for being is “quality and safety”…

This should be simple for an organization that went before Congress stating that the country needed more radiology device accreditation requirements to protect the safety of patients…

It should be simple… but apparently it’s not.

While the ACR MR Accreditation program makes reference to the organization’s industry best-practice MR safety documents, it doesn’t actually require any of the performance criteria be met for accreditation. The ‘safety’ part of ‘quality and safety’ apparently isn’t applicable to the ACR’s MR Accreditation program.

Representatives of the ACR with whom I’ve spoken object, strenuously, to this characterization, insisting that the reason for image quality is to improve the read and patient outcomes, and isn’t that synonymous with safety?

In a word, no.

Yes, image quality holds out the promise of better reads and interpretations, and that is important. But one needs to look no further than the public records of how people are getting injured in the MRI environment. The overwhelming majority of injuries in MRI come down to burns, projectiles, and hearing damage.

If these are the top sources of MRI injury (together comprising more than 90% of FDA-reported incidents from 2009 and 2010 which I evaluated with Dr. Kanal), wouldn’t it seem appropriate that any meaningful MR safety standards would require preventions for at least one of these? The fact is that ACR MR accreditation has no explicit standards that would mitigate any of these types of injuries.

So, despite my thinking that the overwhelming sources of injury in MRI would be at the top of the list of a ‘quality and safety’ MRI accreditation organization’s to-do list, I’ve found myself bargaining, unsuccessfully, with the ACR to support the MRI safety initiatives that they’ve previously promised to implement.

So, Dr. John Patti, Chair of the ACR Board of Chancellors, if you are reading this, please know that my offer still stands. I am willing to call my elected officials and support HR 3269, and all I need in return is an official statement from the ACR that outlines when and how you will honor prior promised to incorporate safety requirements in the MR Accreditation standards.

In the meantime, I’ll be sitting by my computer, waiting for your email.

Tobias Gilk,
President & MRI Safety Director — Mednovus, Inc.
Sr. Vice President —

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