A database designed for utilization management in diagnostic imaging

The methods and tools of health services research have been applied to a di verse number of health care areas. Surprisingly, they have been adopted onl y recently in diagnostic imaging, by a small number of professionals, in re sponse to the severe fiscal constraints and widespread structural changes i n the health industry, as well as to a growing concern that the value of so cial and individual investment in high-cost imaging services could not be v alidated objectively. As a result of the need for accountability for the us e of scarce resources, regulators and payers of health services increasingl y demand that a reasoned and objective evaluative process be adopted. To un dertake a statistically driven evaluative approach that stands up to object ive assessment of methodological rigour, an organized data-collection syste m is needed. Without this fundamental cornerstone, evaluators are left with little more than anecdotal evidence and professional and personal opinion to guide decision-making: It then becomes difficult to learn from both the successes and failures that are routinely experienced during times of rapid and fundamental change. This article describes the efforts made to integra te health services research in radiology into the routine daily activities and supporting systems of a large academic health system, the Hamilton Heal th Sciences Corporation and McMaster University Department of Radiology, in an attempt to move in the direction of evidence-based decision-making. The authors hope this will allow others to learn and improve on this work. Rad iologists may then move the vast data systems and infrastructure associated with all imaging services to an evidence-based model for managing and guid ing the vast resources entrusted to our collective stewardship.