RADPEER ™

1. RADPEER™ Hani Abujudeh MD, MBA, FSIR Associate Professor of Radiology Massachusetts General Hospital Harvard Medical school

2. Disclosures Book Royalties

3. RADPEER™ RADPEER™ is a simple tool developed to allow physicians to do peer review during the course of a day’s work. When a new study is interpreted with an prior study for comparison, a peer review of the accuracy of the interpretation of the previous examination occurs.

4. RADPEER™ • Piloted RADPEER™ in 2001 • Offered to members in 2002 • e RADPEER ™ developed in 2005 • Scoring changes implemented in 2009 4

6. Signal events • American Medical Accreditation Program by the AMA in 1998 • The publication of the, Institute of Medicine report To Err Is Human in March 2000. • An ABMS task force on the maintenance of certification, Competence Initiatives: A Status Report • Listed four components of maintenance of certification, which will be required by all specialty boards • These components are professional standing, commitment to lifelong learning and periodic self-assessment, cognitive expertise, and the evaluation of performance in practice. 6

7. ACR RADPEER • In response to the interests of the public and the health care community, the ACR convened a patient safety task force. • The task force concluded that to meet the fourth requirement of maintenance of certification a successful peer review program must be national, uniform in structure and function across practices, accurate, facile, nonpunitive, and able to be integrated into a facility’s quality assurance program. • The task force concluded that no existing programs met these criteria 7

9. RADPEER ™ Four point scoring system: 1. Concur with interpretation 2. Discrepancy in Interpretation/not ordinarily expected to be made (understandable miss) a. unlikely to be clinically significant b. likely to be clinically significant 3. Discrepancy in Interpretation/ should be made most of the time a. unlikely to be clinically significant b. likely to be clinically significant 4. Discrepancy in Interpretation/ should be made almost every time - misinterpretation of finding a. unlikely to be clinically significant b. likely to be clinically significant Scores of 2b, 3 or 4 should be reviewed through the facility’s internal QA process prior to submission to ACR 9

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14. The median number of cases reviewed in RADPEER is 776 each year, which translates into 3 to 4 cases reviewed per working day. • The RADPEER system is not designed to be a sole OPPE measure, but it can be incorporated into such programs. The committee discourages the use of scores as a means of competency assessment and encourages the maintenance of the nonpunitive nature and anonymity in scoring. • RADPEER could be expanded and used as a means to collect data on other aspects of quality and safety in radiology. 14

15. Improving the performance of the system as a whole is far more beneficial than eliminating the outliers (Deming, W.E., Out of the Crisis2000, cambridge: MIT Press.) ( assessing competence vs improving performance)

16. RADPEER™ • April 2014 • Over 1,170 participating groups • Over 17,500 physicians 16

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19. RADPEER™ • Data submitted to ACR via website • Reports for individuals and group available electronically • ABR MOC Reports 19

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22. RADPEER™ as a PQI Project • Radiologists can select RADPEER™ to be used as one of their projects for Maintenance of Certification for the ABR (American Board of Radiology) • The MOC process includes: • Evidence of professional standing (license) • Lifelong learning and self-assessment (SAMs, CME) • Cognitive expertise (exam) • Practice quality improvement (PQI project such as RADPEER™) 22

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24. Cost of RADPEER™ Participation • Annual fee for participation in RADPEER™ is based on the number of physicians in the group 24

25. https://radpeer.acr.org habujudeh@partners.org 25