Ed Nicol, Mark Ibrahim, Benjamin J Cohen, Jonathan R Weir McCall, Ron Blankstein, Leslee J Shaw
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引用次数: 0
摘要
最近,美国医疗保险和医疗补助中心(Centers for Medicare and Medicaid)提出了一项分类改革建议,如果该建议获得通过,美国冠状动脉 CT 血管造影术(CCTA)的报销额度将增加一倍[1]。这样一来,就有可能在主要城市(医院和私人诊所)和学术中心之外建立一种经济上可行且可持续的心脏 CT 服务模式。CCTA 在降低心血管疾病发病率和死亡率方面的价值已在大型随机对照试验和实际研究中得到证实,但在农村、社会贫困地区和资源匮乏地区(包括缺乏专业设备和专科服务的较贫困城市地区)获得 CCTA 仍是一项重大挑战。本文讨论了在这些地区提供可持续的心脏 CT 服务所需的端到端业务方面,探讨了由技术专家提供的服务、医生的远程支持以及利用开发中的人工智能 (AI) 决策辅助工具和移动扫描仪的潜力。
A new business paradigm to make coronary CT angiography (CCTA) accessible to all.
Recently, the Centers for Medicare and Medicaid proposed a classification change that, if enacted, could double reimbursement for coronary CT angiography (CCTA) in the U.S. [1]. With this comes the potential to realistically build an economically viable and sustainable model to deliver cardiac CT outside of major urban (hospital and private practice) and academic centers. The value of CCTA in reducing cardiovascular morbidity and mortality has been demonstrated in large, randomized control trials and real-world studies, but access to CCTA in rural, socially deprived, and low-resource settings (including poorer urban areas with a lack of specialist equipment and specialty-based services) remains a significant challenge. This paper discusses the end-to-end business aspects required to deliver a sustainable cardiac CT service in these areas, exploring technologist-delivered services, with remote support from physicians, and the potential to leverage developing artificial intelligence (AI) decision aid tools and mobile scanners.