The Alara Imaging Gateway: Linking Electronic Health Records and Radiology Imaging Exams to Report on National Quality Measures to Reduce Cancer Risk from Computed Tomography (Alara Imaging Gateway)

摘要 Alara成像公司(Alara)正在寻求资金，以支持强大的、受IP保护的HIPAA- 合规的商业质量软件，用于计算和报告将要报告的质量度量 全国每一位放射科医生和医院集团。此外，阿拉拉正在寻求资金，以开发增强型 利用机器学习、数据可视化和基准测试的反馈，指导医生和 医院正在研究降低CT辐射剂量的安全方法。一旦通过以下方式大规模实施 在这一奖项的支持下，Alara的软件有可能将CT导致的癌症减少高达 30%，每年预防多达10,000种癌症。 在过去的20年里，CT的使用大幅增长，每年进行9000万次CT检查 美国在CT的性能上存在一个主要的质量差距，因为这些检查所使用的辐射剂量是 高于诊断所需的水平，并且在增加个人患癌症风险的范围内；它 据估计，CT的使用每年在美国导致36,000例癌症。1.CT检查方法的不一致 实施代表可改变的健康风险，因为辐射剂量可以通过审计和反馈来减少， 如加州大学旧金山分校领导、NCI资助的试验所示。 2019年，加州大学旧金山分校获得CMS的合作协议，开发CT辐射剂量和图像 该机构的绩效工资计划中使用的质量衡量标准。这个奖项的目的是为了 激励放射科医生和医院，通过财政减少不必要的高辐射剂量 激励措施。加州大学旧金山分校创造了一种方法，通过结合位于以下位置的临床和放射学数据来判断每个CT 不同的健康数据系统，包括电子健康记录、放射信息系统和 图像存档和通信系统。这些数据系统通信很差，而且很正常 实时摄取和标准化这些数据是一项技术挑战。此外，作为……的规定 CMS要求加州大学旧金山分校将这些措施发展为电子临床质量衡量标准(ECQM)； 然而，在国家一级制定和实施全面质量管理所需的资源超出了 来自CMS的Smith-Bindman博士。因此，史密斯-宾德曼博士与加州大学旧金山分校合作 少数股权利益相关者，与放射学信息学专家合作创建了一个商业实体Alara，以 制定国家实施的环境质量管理体系和软件。目前正在考虑采取这些措施 在CMS高质量支付计划中使用，Alara现在正在寻求资金，以大规模实施这些措施。 除了CMS测量功能之外，软件的体系结构将代表一个有意义的 技术进步，并通过链接和提供访问来创造超越测量报告的价值 将临床和放射学数据连接到云中。信息技术公司是 使用新的机器学习和计算机视觉技术推动放射学的护理需要访问 相同的关联数据，以便他们可以利用现代技术应用程序。Alara的软件，“The Gateway“，解决了这一集成和数据访问挑战，Alara将向 科技公司，为科技公司开发更多解决方案打开了可能性 链接和结构化数据的优势。

Abstract Alara Imaging, Inc. (Alara) is seeking funding to support the development of robust, IP-protected, HIPAA- compliant commercial quality software to calculate and report on quality measures that will be reported for every radiologist and hospital group in the nation. Further, Alara is seeking funding to develop enhanced feedback that leverages machine learning, data visualization, and benchmarking to guide physicians and hospitals on safe approaches for lowering their CT radiation doses. Once implemented at scale through the support of this award, Alara’s software has the potential to reduce the cancers that result from CT by up to 30%, preventing as many as 10,000 cancers annually. The use of CT has grown substantially over the last 2 decades with 90 million CT exams performed annually in the U.S. A major quality gap exists in the performance of CT as the radiation doses used for these exams are higher than needed for diagnosis and in the range where they increase a person's risk of developing cancer; it is estimated that CT use causes 36,000 cancers annually in the U.S.1 The inconsistency in how CT exams are performed represents a modifiable health risk as radiation doses can be reduced through audit and feedback, as shown in a UCSF led, NCI funded, trial.2 In 2019, UCSF was awarded a cooperative agreement from CMS to develop CT radiation dose and image quality measures for use in the agency’s pay-for-performance programs. The intent of this award was to motivate radiologists and hospitals and to reduce unnecessarily high radiation doses through financial incentives. UCSF created the approach to judge each CT by combining clinical and radiology data located in disparate health data systems including the Electronic Health Record, Radiology Information System, and Picture Archiving and Communication System. These data systems communicate poorly, and properly ingesting and normalizing these data in real time was a technological challenge. Additionally, as a stipulation of the funding, CMS required UCSF to develop these measures as electronic clinical quality measures (eCQM); however, the resources required to develop and implement an eCQM at the national level were beyond what was available to Dr. Smith-Bindman from CMS. As a result, Dr. Smith-Bindman, in collaboration with UCSF as a minority equity stakeholder, worked with radiology informatics experts to create a commercial entity, Alara, to develop the eCQMs and software for national implementation. The measures are now being considered for use in CMS quality payment programs, and Alara is now seeking funding to implement the measures at scale. In addition to the CMS measure functionality, the software’s architecture will represent a meaningful technological advancement and creates value beyond measure reporting by linking and providing access to combined clinical and radiology data connected to the cloud. Information technology companies that are driving care forward in radiology using novel machine learning and computer vision techniques need access to the same linked data so that they can leverage modern technology applications. Alara’s software, “The Gateway”, solves this integration and data access challenge, and Alara will sell access to the Gateway to technology companies, opening possibilities for technology companies to develop additional solutions that take advantage of the linked and structured data.