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Updates to the MRI Protocol and Clinical Guidelines for MS: CMSC Working Group - Episode 10

Payer and Patient Education of the Standardized Examination

David Li, MD, FRCPC: One of the things that we also talked about yesterday was in terms of the education of the payers, how the scan that they’re paying for is going to be of use, is our efforts to try and make sure that neurologists understand the importance of a standardized examination. My understanding is that many patients who are looked after in the United States are not necessarily looked after in MS [multiple sclerosis] centers. That is something that may not be as familiar to people who may not see hundreds of MS patients in a year. It’s important for them to understand how valuable a standardized examination is.

On the other side of it is we need to have more efforts in terms of letting patients understand how important the scan is for them in their care. Now that patients are much more engaged in their own management, I think it’s something that will be very important, for them to not have scans done in a place where they’re not going to benefit from it.

They’re paying for it, and yet the scans may need to be repeated, which will be additional cost. The patients are very important in this whole cycle because they’re the ones who could, when they go to the center, ask specifically, “Are you doing this?” If those cards that we’re talking about become available, I’d love to have patients have those cards, where they can show up and say, “Are you doing it this way?”

Scott D. Newsome, DO, MSCS, FAAN: I love that idea. It’s really to have the patient’s voice.

June Halper, MSN, APC-C, MSCN, FAAN: The technician won’t love it, but….

David Li, MD, FRCPC: The technologists would love it, too, because they don’t have to repeat it…and the radiologists reporting it will say this is easier to report. This is because, if you’ve got scans that are compatible and consistent, the life of the radiologist is far improved than trying to match scans that are angled all over the place with different thicknesses and different sequences.

June Halper, MSN, APC-C, MSCN, FAAN: Exactly. What about in Europe, are you finding the patients more proactive and advocating a lot more for care?

Frederik Barkhof, MD, PhD: No, I think the patients don’t realize. They just think they need to have an MRI [magnetic resonance imaging] scan, and they don’t realize that an MRI scan consists of various parts, which you can all tune. They may perhaps realize, “Oh, the last time it was my brain and now my spine. Why is it different?” But otherwise they won’t notice.

June Halper, MSN, APC-C, MSCN, FAAN: I guess it’s the Internet….

Scott D. Newsome, DO, MSCS, FAAN: Sorry to interrupt. I was going to say that partnering with other groups like the National Multiple Sclerosis Society is a great idea. This is another avenue to engage and disseminate, especially from the patient perspective. This is because I’ve had some patients, I’m sure you have as well, come in saying, “Oh, I read this on X website, and tell me about this.” The patient has a strong voice, and so I could see almost that, “Oh, I read about these guidelines. Am I getting 2019 guideline-related MR [magnetic resonance] imaging?” So, I think that that’s….

Frederik Barkhof, MD, PhD: Then they also read the reports. I don’t know whether you do that, but in our hospital, we allow them to log in, and so they actually read the reports. If they then read that it’s done with different protocols and difficult to compare, they will wonder, “Why is it so different, and why didn’t I get the right scan the previous time, or this time?”

June Halper, MSN, APC-C, MSCN, FAAN: Absolutely. Everybody’s got access now to their laboratory results and their medical record. Hopefully we’ll get some push from the patient end toward the payer saying, “I want to go to this unit because they’re doing the protocol.”