The MR Value Initiative

Dear Friends and Colleagues,

I want to tell you about a new and evolving ISMRM initiative intended to broaden the scope of MR in clinical practice.  This initiative will not impact every member directly, but its goal – to increase the robustness of MR in the context of changing healthcare economics – should benefit all.

As healthcare costs rise across the globe, expensive technologies such as MRI come under increasing scrutiny.  Most in the ISMRM understand the incredible diagnostic information one can obtain with MR, but perhaps we can better scrutinize how MR is used, where it is – and is not – cost effective, given the options of care and their respective impacts on patient outcomes.  This scrutiny is happening, with or without us – shouldn’t we be part of the conversation?

Identifying areas of high and low utility, and opening up new areas where MR is highly cost effective, will increase the future robustness of the MR field.  Along the way, a major goal of this initiative is to help our researchers identify areas for invention and development with high clinical impact.  Another is to harness the expertise and breadth of our clinical members to gather the data necessary to affect real change in standard of care.  Given our scope of technical and clinical excellence in MR, the ISMRM is in a unique position – and perhaps even has a unique responsibility – to address these global economic concerns without sacrificing the quality of care for our patients.

Clinically speaking, the term “Value” can relate to the impact on patient outcomes, or to the production of actionable, diagnostic information.  The first is more important, the latter is more easily measured, but in either case it needs to be normalized by the cost of providing the MR exam.  While we hope this initiative increases the discussion of MR value on many fronts, there are a few particular areas where we are planning real steps to move forward.  I’m writing this early in the process, so some of what I write may change – but I want to give you all time to reflect, and also a chance to give input to affect the course of this endeavor.

The first visible expression of this initiative will be the “High-Value MR Exam” campaign.  No, it’s not a political campaign, but rather an activity designed to affect change – an effort to improve standard of care by opening up the scope of MR in clinical practice.  We will launch this campaign in detail at our 2016 annual meeting in Singapore – but in the meantime, think of the following scenario:  If a patient comes in with a particular history or indication, and the clinician needs to answer a single question – is there a faster way to reliably obtain the answer with MR?

A second campaign, possibly to launch at the 2017 annual meeting, may explore rapid exams which are cost-effective enough to provide the initial diagnosis – perhaps not as thorough as a “full” MR exam, but good enough to triage patients more cost effectively than other modalities.  Maybe this means faster scans, synthetic MR, fingerprinting, a new form of contrast, or something else.  I think this campaign will be very interesting, very fun, and very impactful.

Jim Pipe, Ph.D.
ISMRM President, 2015-2016