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Manitoba initiates pilot to improve choice of DI tests

WINNIPEG – An innovative pilot project at Children’s Hospital could lead to shorter wait times for diagnostic tests such as MRI and CT scans, Health Minister Tim Sale (pictured at left) said.

The $1-million project involves the use of electronic order entry software that will assist physicians making referrals to choose the most appropriate diagnostic imaging test for each patient. It does this at the time the test is
ordered by providing the physician with electronic guidelines for diagnostic imaging that have been adopted by the Canadian Association of Radiologists (CAR).

The criteria, which are embedded in the software, should reduce the number of unnecessary or inappropriate tests.
CAR estimates that 3.5 million diagnostic tests performed each year in Canada are unnecessary or inappropriate, in part, because many doctors are not aware of appropriate clinical criteria.

“Shortening waiting times means ensuring the appropriate procedures are performed on the right patients. Ultimately our goal is to change the way wait-lists are managed and created,” said Sale. “We need to add more capacity to
perform more scans but we also need to make sure these scans are necessary and we are more efficient with the resources we have.”

The project is a partnership between Manitoba Health, CAR and Health Canada and is implemented through the Winnipeg Regional Health Authority.

“Manitoba is the only province to make the demand-side of diagnostic wait-lists a top priority and should be commended for showing leadership on what is a critical wait-time issue,” said Normand Laberge, CEO of CAR.

“This project has great potential to free up capacity that is currently tied up with inappropriate usage, resulting in a reduction of wait times for all patients as well as cost savings,” said Laberge, who compared the issue to the
way engineers address highway traffic problems. “Obviously you have to build the highway, but once you have built it you have to deal with the way it is used or you will continue to have congestion problems.”

“I am very pleased that the Manitoba government and Health Canada have committed to working with CAR on this project,” said project director Dr. Martin Reed of the Children’s Hospital at the Health Sciences Centre. “As chair of the CAR Guideline Committee, I am particularly pleased that this project is being carried out at Children’s Hospital. I think it is important for pediatric patients because we want to ensure children are exposed to the least possible
radiation for appropriate diagnosis. These guidelines will help achieve that.”

“Our goal is to provide better care sooner to patients and this initiative, like all of our wait-list initiatives, is in pursuit of that goal. Changing the way we do things is at the heart of it,” said Sale.

The two-year project is cost shared between Health Canada and the province, with Manitoba’s share coming out of the $25.5 million designated to improve diagnostic wait times in the $155 million Wait Times Reduction Fund announced in October 2005.