Title: Appropriate Resource Utilization – Imaging and Medications
Regulation COC OMH Accreditation Standard 3.1, Med Solutions
Reference: Oncology Imaging Guidelines, Cancer.net (ASCO)
Policy Number:
Effective Date:
Purpose:
Appropriate resource utilization incorporated evidence-based guidelines to assist physicians and other
providers in making the most appropriate imaging and medication decisions for a specific clinical
condition. By employing these guidelines, our clinicians can enhance the quality of care and
contribute to the most efficacious use of radiology and pharmaceuticals.
Policy:
Personnel affected: Physicians, Advanced Practitioners, Nursing, and Medical Assistants
It is the policy of XXXXX to use our resources widely and within the recommended guidelines for
oncology. Cancer patients tend to require a lot of testing and imaging. It is our goal to reduce this amount
to only what is recommended unless absolutely necessary.
Procedure:
After the order is written and received the Medical Assistants and/or Nursing must obtain prior
authorization from the patient’s insurance company prior to scheduling imaging or administering
medications.
Imaging
Minimizing Advanced Imaging for Stage 1 or 2 Prostate Cancer
1. We will not order an endorectal MRI and/or multi-parametric MRI to define low risk disease,
this is considered investigational and experimental
2. For patients under active surveillance for disease progression but who have not received any
treatment the recommendations are a PSA every 6 months, a digital rectal exam every 12
months, and a repeat prostate biopsy every 12 months
3. MRI of the pelvis should not be used for patients under active surveillance
4. PET shall not be ordered for diagnosis and initial staging
Minimizing Advanced Imaging for Stage 1 or 2 Breast Cancer
1. We will not utilize the following tests for staging DCIS or Stage 1 or 2 Breast Cancers
CT Scan
PET Scan
Bone Scan
DCIS and Stage 1 or 2 breast cancers have a low risk of having spread outside of th breast
and nearby lymph nodes when diagnosed. Research on these tests has shown that they are
often falsely positive and expose people to unnecessary radiation and no help to lengthen
lives.
Medications
Treatment guidelines are outlined by Pharmacy and Therapeutics Committee, based on NCCN
recommendations and approval by physician staff.
Responsibility and Approval Authority:
This policy shall be reviewed by the appropriate committees, managers and staff to whom it is relevant, approved by the
Executive Committee of the Board, with final signatory authority of the Medical Director.
Version Number:
Original Approval Date:
Reviewed
Date:
Prepared by:
Approved by:
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