How do we enhance patient care and contain costs? By determining IF a radiology imaging test is necessary. The question that too often is being asked, by regulators aiming to contain costs, is how many imaging tests were ordered or performed. A given patient population may require more imaging tests than another. Regulators attempt to determine the answer to "how many" and "how much" with cost-cutting algorithms that may not be appropriate on a case-by-case basis.

Patient care can improve with decision support models such as ACRSelect, which is a program that is designed to assist medical providers when ordering radiology imaging tests/procedures. Using ACR Appropriateness criteria, the use of ACRSelect can improve the ordering process by ensuring that tests that are ordered are appropriate from an evidence-based standpoint.

But much more is needed than a passive, front-line, computer order entry assistant.

Radiologists are in the best position to assist our clinical colleagues when ordering radiology imaging tests and procedures. While ordering tests/procedures has traditionally been thought of as the purview of the "ordering" physician, few know better than radiologists the irony of the federal regulators who continue to look to radiology as a source for reimbursement cuts.