Today’s Top Story
Radiology initiative attempts to reduce use of unnecessary scans.
An article in HealthLeaders Media profiles an initiative at a Boston hospital system designed to reduce the likelihood of unnecessary high-end scans such as magnetic resonance imaging, computed tomography, and positron emission tomography. Under the program, when an imaging test is ordered using the hospital’s radiology order entry portal, an appropriateness score is returned based on a patient’s signs, symptoms, and known diagnoses. A 7, 8, or 9 (green) means the test is usually appropriate for a specified indication. A 4, 5, or 6 (yellow) suggests that the scan may be appropriate, while a 1, 2, or 3 (red) suggests that it is usually not appropriate to the indication. The system always allows physicians to use their own judgement and order red-rated scans, but over time, physicians are monitored to compare their ordering habits against their peers. Read more…

Other News

Study: UTI may occur in about one of 56 patients who undergo posterior lumbar fusion.
A study published online in the journal Spine attempts to identify risk factors for urinary tract infection (UTI) following posterior lumbar fusion. The researchers conducted a retrospective review of prospectively collected data on 10,825 patients. They found the incidence of UTI was 1.77 percent. Overall, independent risk factors for UTI were older patients, female sex, dependent functional status, malnutrition, diabetic status (increased risk for insulin-dependent diabetes), and increased operative duration. In addition, the researchers noted that patients with UTI were at increased risk for systemic sepsis and readmission compared to patients without UTI. Read the abstract…

Study: Genetic factors and race interact to influence warfarin dosages.
Findings from a study published online in the journal Blood suggest that the effect of predictors on warfarin dose may differ by patient race. The authors conducted a prospective cohort study of 1,357 patients to compare predictive ability of race-combined versus race-stratified models among European Americans and African Americans. They found that warfarin dose was influenced by age, body surface area, chronic kidney disease, amiodarone use, and genetic factors (CYP2C9*3 and VKORC1 variants in both races, CYP2C9*2 and CYP4F2 variants in European Americans, and rs12777823 in African Americans). Overall, the presence of CYP2C9*2 was associated with a lower dose only among European Americans and the presence of rs12777823 was associated with a lower dose only among African Americans. VKORC1 was associated with dose decrease in both races, but the proportional decrease was higher among European Americans compared to African Americans. The authors note that race-stratified analysis improved dose prediction in both race groups compared to race-combined analysis. Read more…
Read the abstract…

Eight states have enacted the Interstate Medical Licensure Compact.
Alabama and Minnesota have become the seventh and eighth states to enact the Interstate Medical Licensure Compact, triggering the formation of the Interstate Medical Licensure Compact Commission. The goal of the commission is to administer a streamlined process for physicians seeking to obtain licensure in multiple states. Other states that have enacted the compact include Idaho, Montana, South Dakota, Utah, West Virginia, and Wyoming; bills to enact the compact have been introduced in at least nine other states. Read more…
Learn more about the Interstate Medical Licensure Compact…

June 30 is the deadline for physician groups to register for the 2015 PQRS GPRO.
The U.S. Centers for Medicare & Medicaid Services is reminding groups that they have until June 30 to register to participate in the 2015 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) via the Physician Value—Physician Quality Reporting System (PV-PQRS) registration system. PQRS GPRO is available to groups with two or more eligible professionals. Groups must meet the satisfactory reporting criteria through the PQRS GPRO in order to avoid the 2 percent CY 2017 PQRS negative payment adjustment. Read more…

California.
The Associated Press reports that a bill under consideration in the California State Legislature would, if enacted, require physicians in California to check the state’s Controlled Substance Utilization Review and Evaluation System (CURES) database before prescribing opioids to a patient. Currently, use of the CURES database is voluntary. At least nine other states require physicians to check their respective drug databases before prescribing certain medications. Read more…

New AAOS Now podcast on the Orthopaedic Device Forum.
AAOS Now has released an audio interview in which William M. Mihalko, MD, PhD, speaks with AAOS Now Managing Editor Mary Ann Porucznik, about the Orthopaedic Device Forum. Listen to the current podcast (MP3)…
    Other podcasts are available by clicking on “podcast” in the left navigation column of the AAOS Now home page. View all AAOS Now podcasts…

Last call: CMS TEP on preventable readmission measures for post-acute care.
AAOS seeks to nominate members to the CMS Technical Expert Panel (TEP) on Development of Potentially Preventable Readmission Measures for Post-Acute Care. As part of the measure development process, CMS is asking measure contractors to convene groups of stakeholders and experts for direction and thoughtful input during measure development and maintenance. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, a letter of interest highlighting their expertise in the subject area, and a conflict of interest (COI) form. All supporting materials must be submitted by Saturday, May 30, 2015 at 11:59 p.m. CT. To request a COI form and submit supporting materials, please contact Kyle Shah, at shah@aaos.org.
Learn more and submit your application…