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)

Alara 成像网关：将电子健康记录和放射成像检查联系起来，报告国家降低计算机断层扫描癌症风险的质量措施 (Alara Imaging Gateway)

• 批准号: 10820279
• 负责人: Nathan Mazonson
• 金额: $ 131.63万
• 依托单位: ALARA IMAGING INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10820279
• 关键词: Adoption; Architecture; Automobile Driving; Award; Benchmarking; California; Caring; Categories; Certification; Clinical; Clinical Data; Clinical/Radiologic; Collaborations; Communication; Computer Vision Systems; Computer software; Data; Development; Diagnosis; Digital Imaging and Communications in Medicine; Dose; Electronic Health Record; Electronics; Equity; Fast Healthcare Interoperability Resources; Feedback; Funding; Graph; Health; Health Insurance Portability and Accountability Act; Health Status; Healthcare Systems; Hospitals; Image; Informatics; Information Systems; Information Technology; Ingestion; Inpatients; Intellectual Property; Interview; Link; Machine Learning; Malignant Neoplasms; Measures; Medical Imaging; Minority; Modernization; Outpatients; Patient imaging; Patients; Performance; Persons; Physicians; Picture Archiving and Communication System; Radiation; Radiation Dose Unit; Radiology Information Systems; Radiology Specialty; Randomized, Controlled Trials; Recommendation; Report (document); Reporting; Resources; Risk; San Francisco; Secure; Services; Site; Source; Specific qualifier value; Standardization; Surveys; System; Techniques; Technology; Testing; Time; U-Series Cooperative Agreements; United States Centers for Medicare and Medicaid Services; Universities; Visualization; Work; X-Ray Computed Tomography; cancer diagnosis; cancer risk; comparative; data access; data management; data visualization; electronic health data; financial incentive; firewall; health disparity; imaging facilities; imaging software; novel; patient safety; payment; peer; prevent; programs; radiological imaging; radiologist; service organization; software development; structured data; success

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.

摘要 Alara Imaging，Inc.（Alara）正在寻求资金来支持开发强大的、受知识产权保护的HIPAA- 合规的商业质量软件来计算和报告质量措施， 全国所有的放射科医生和医院此外，Alara正在寻求资金，以开发增强的 利用机器学习、数据可视化和基准测试来指导医生和 医院安全的方法来降低他们的CT辐射剂量。一旦通过 在该奖项的支持下，Alara的软件有可能将CT导致的癌症减少多达 30%，每年预防多达10，000例癌症。 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， CT的性能存在重大质量差距，因为用于这些检查的辐射剂量 高于诊断所需的水平，并且在增加一个人患癌症风险的范围内; 据估计，在美国，CT的使用每年导致36，000例癌症。 由于辐射剂量可以通过审计和反馈减少， 如UCSF领导的NCI资助的试验所示。 2019年，UCSF获得CMS的合作协议，开发CT辐射剂量和图像 质量措施，用于该机构的绩效工资计划。该奖项的目的是 动员放射科医生和医院，并通过财政资助减少不必要的高辐射剂量。 激励加州大学旧金山分校创建的方法来判断每个CT结合临床和放射学数据位于 不同的健康数据系统，包括电子健康记录，放射信息系统， 图像处理和通信系统。这些数据系统的通信很差， 在真实的时间内输入和规范这些数据是一项技术挑战。此外，作为一项规定， 资金，CMS要求UCSF开发这些措施作为电子临床质量措施（eCQM）; 然而，在国家一级开发和实施电子计算机质量管理所需的资源超出了 CMS的史密斯·宾德曼博士可以使用因此，史密斯-宾德曼博士与UCSF合作， 作为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， 开发电子能力建设质量管理系统和软件，供国家实施。目前正在考虑采取这些措施， 在CMS质量支付计划中使用，Alara现在正在寻求资金来大规模实施这些措施。 除了CMS测量功能之外，软件的架构将代表一个有意义的 技术进步，并通过链接和提供访问， 将临床和放射学数据连接到云端。信息技术公司， 使用新型机器学习和计算机视觉技术推动放射学护理向前发展需要访问 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 技术公司，为技术公司开发其他解决方案提供了可能性， 链接和结构化数据的优势。