Canada to pursue decision support for imaging exams

By Louise Gagnon, contributing writer

December 18, 2020 -- Diagnostic imaging referral guidelines would be integrated digitally into clinical decision-support (CDS) systems in an attempt to optimize the ordering of medical imaging exams in Canada under a new initiative backed by the Canadian Association of Radiologists (CAR) and the Canadian Medical Association.

By working to ensure appropriate selection of imaging tests by referring clinicians, the project has the potential to decrease wait times for medical imaging in Canada, according to Dr. Ryan Margau, chief radiologist and medical director of the department of medical imaging at North York General Hospital in Toronto.

In 2018, the average Canadian could have been waiting up to 82 days for medical imaging, a 2019 report by the Conference Board of Canada concluded. And the COVID-19 pandemic has further lengthened wait times.

"This is not about being punitive or restrictive (in the ordering of imaging tests)," said Margau, who is also co-chair of the CAR's Referral Guidelines Working Group. "It is about helping to select the right test at the right time. And the hope is, that by doing that, we could help improve access and improve patient care."

The guidelines will be freely available, and the CAR will publish the guidelines online so that they can be accessed for Canadian hospitals that do not yet have CDS systems and electronic medical records.

Because Canadian clinicians may not have ready access to modalities like PET or even MRI, depending on their geographic location, the diagnostic referral guidelines will outline imaging choices when there isn't access to more advanced modalities, Margau explained. "This effort is really about summarizing the evidence and putting it in a Canadian context for the Canadian system."

As diagnostic imaging referral guidelines do not remain static and evolve with evidence from the literature, radiologists will continually update the guidelines, Margau noted.

The partnership between the CAR and the Canadian Medical Association is scheduled to begin in January, according to an article on the CAR website. Margau's working group will spearhead the development of the guidelines in consultation with the radiology community and groups representing referring physicians.

Copyright © 2020

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