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Using Patient Registries to Improve Care:
PQRS, MQSA and Beyond

Using Patient Registries to Improve Care:
PQRS, MQSA and Beyond

Gregory N. Nicola, MD, vice president, Hackensack Radiology Group, Oradell, N.J., concurs. He notes that in affording radiologists, imaging centers and hospital-based imaging players an avenue for formulating and comparing national benchmarks, registries set the stage for improving the caliber of care delivered to patients. “The term ‘quality’ can be tricky to interpret, and it can be difficult to determine exactly what needs to be done to achieve or improve it unless you’re looking at objective measures, instead of through your own lens,” Nicola asserts. “For instance, without the National Mammography Database in place, who really is to say that the mammography recall rate for a particular practice isn’t high enough—or too high, for that matter—to contribute to quality care?”

He adds that increasing the automation of objective quality metrics through participation in such registries as those that fall under the NRDR umbrella also gives practitioners additional time for conducting internal peer reviews and leveraging internal quality control programs. This, too, has a heavy bearing on caliber of care and the overall patient experience.

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The New MACRA Committee

The Commission on Economics goes into
operational mode as it approaches new payment

Gregory N. Nicola, MD - Committee Chair Appointment

The Commission on Economics has known for years that a transition from volume- to value-based payment is inevitable. As early as 2001, “Crossing the Quality Chasm: A New Health System for the 21st Century,” a report published by the Institute of Medicine, called for “aligning payment policies with quality improvement” and “bundled payments for priority conditions.”

There have been a number of policies moving toward this goal, but changes have been implemented relatively piecemeal. Accordingly, the Commission on Economics has taken action and made recommendations that were largely predictive of what may be required of radiology in the future. Under the visionary leadership of our past chair, Geraldine B. McGinty, MD, MBA, FACR, we created the Value-Based Payments Committee, the ACO Committee, the Radiology Integrated Care Network, and, more recently, the Merit-Based Incentive Payment System (MIPS) Workgroup.

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Sports medicine radiologist Jana Crain is exceedingly grateful for her Arkansas roots as she has grown into a Redwood-size deal out West.

HIGH PROFILE: Sports medicine radiologist Jana Crain is exceedingly grateful for her Arkansas roots as she has grown into a Redwood-size deal out West

ATHERTON, Calif. -- Some of the most respected physicians in the country point to a Star City native as one of the best sports medicine radiologists in the business.

Dr. Jana Crain, a radiologist who now lives in the San Francisco Bay area, demurs, saying she certainly wouldn't say that of herself.

"I feel like I stand on the shoulders of giants," she says of her mentors -- some of whom she met while she was a student at the University of Arkansas for Medical Sciences in Little Rock. "It takes a village, and I feel like there were just so many people who were supportive of me and encouraged me."

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ACR Statement on Safe Resumption of Routine Radiology Care During the Coronavirus Disease 2019 (COVID-19) Pandemic:

Dr.Nicola co-authored the ACR Statement on Safe Resumption of Routine Radiology Care During the Coronavirus Disease 2019 (COVID-19) Pandemic


The ACR recognizes that radiology practices are grappling with when and how to safely resume routine radiology care during the coronavirus disease 2019 (COVID-19) pandemic. Although it is unclear how long the pandemic will last, it may persist for many months. Throughout this time, it will be important to perform safe, comprehensive, and effective care for patients with and patients without COVID-19, recognizing that asymptomatic transmission is common with this disease. Local idiosyncrasies prevent a single prescriptive strategy. However, general considerations can be applied to most practice environments.


A comprehensive strategy will include consideration of local COVID-19 statistics; availability of personal protective equipment (PPE); local, state, and federal government mandates; institutional regulatory guidance; local safety measures; health care worker availability; patient and health care worker risk factors; factors specific to the indication(s) for radiology care; and examination or procedure acuity. An accurate risk-benefit analysis of..

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Dr. Rebecca Gamss, Breast Radiologist at Hackensack Radiology Group/Hackensack University Medical Center, notes, “We are seeing cases of women with new enlarged axillary lymph nodes on the same side as their Covid vaccine.:

Local Reactions After Covid-19 Vaccine Can Mimic Signs Of Breast Cancer


Minor reactions following Covid-19 vaccination are common, and can include fever, chills, fatigue, body aches, a bump or redness at the injection site, or lymph node swelling. All of these are signs that the immune system is appropriately responding by developing antibodies. This is a good thing (although do not fear if you have no reaction at all— this is also fine). These reactions are more commonly seen in younger individuals, and because lymph node swelling tends to develop as a reaction to a nearby area of the body, the nodes in the armpit region can become inflamed after the Covid-19 vaccine. As these lymph nodes are near the outer breast tissue, women have raised valid concerns that these lymph nodes are breast masses or breast cancer metastases.

As one in eight women will develop breast cancer in her lifetime, this is an important distinction to address. Because as common as breast cancer is, inflamed lymph nodes due to breast cancer are very rare, and cause for more concern. Less than 0.5% of patients with breast cancer present with axillary (armpit) lymph nodes, but when they are present in the setting of cancer, there is a 50% chance that they are either cancerous or representing another type of cancer such as leukemia or lymphoma. This finding has led many women to seek early evaluation, including surgical consultations and mammography or ultrasonography to assess these lymph nodes following their Covid-19 vaccine.

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