The Definitive Guide and Checklist for 2017 IAC Nuclear/PET Report Compliance
Updated on October 18th, 2017 by Jim McGee, BS CNMT NCT
We’ve just published our new Definitive Guide & Checklist for 2017 IAC Nuclear/PET Report Compliance.
NOTE: ICANL changed its name to IAC Nuclear/PET in 2012.
Many people still call them “ICANL”, but we’ll refer to them as IAC Nuclear/PET in this article.
Our Guide & Checklist:
- Organizes the report requirements into meaningful categories
- Explains the requirements clearly
- Itemizes them into individual elements (with check-boxes)
- States what the current ASNC-standardized terminology is for defects
- Allows you to easily assess your compliance
- Gives you room for notes regarding any action steps you may need to take to achieve full compliance
Here’s a sample page from the Guide & Checklist:
The IAC Nuclear/PET (formerly ICANL) requirements for nuclear cardiology final reports are complex, exacting & hard to understand. Many IAC Nuclear/PET accredited labs still struggle to comply.
Many IAC Nuclear/PET accredited labs still struggle to comply with IAC’s Report Requirements.
In March 2017, the new IAC Nuclear/PET went into effect:
- They clarified their 2012 report requirements
- And also added some new requirements
Then in September of 2017, ASNC released their new reporting standards:
- This is relevant because the IAC recommends a standardized report consistent with ASNC’s guidelines
Previously we have published 2 white papers:
- One that clearly explained all of the 2012 requirements &
- One that covered only what was new for the 2017 standards
Our new white paper supersedes & replaces the previous white papers:
- It addresses the entirety of the 2017 IAC nuclear cardiology reporting requirements.
The Importance of Final Reports
In a 2011 article in the Journal of Nuclear Cardiology, Tilkemeir et al. nicely summarized the importance of the nuclear cardiology final report:
“The report from any testing facility to the requesting physician is the single most important part of the test as it communicates the result of the test to the patient’s health care provider, allowing them to act on the result and provide meaningful care.
The importance of this communication has been emphasized in both the cardiology and the radiology literature for more than a decade and has recently received increased emphasis in an effort to reduce repeat testing and control cost.
Myocardial perfusion imaging serves as the ‘‘gatekeeper’’ for an increasing number of invasive cardiology procedures that are performed as a result of the myocardial perfusion imaging study.
Therefore, it is essential that the results are reported accurately and concisely to reduce the need for unnecessary and repetitive testing and decrease patient risk.”
History of Report Compliance
One of the most difficult aspects of achieving and maintaining IAC Nuclear/PET accreditation has always been final report compliance.
The most recent study that evaluated nuclear lab’s compliance with the reporting standards showed that a significant percentage of labs still have report deficiencies, even after 3 accreditation cycles:
The researchers concluded that report compliance did improve over time, however, labs still struggle in the following areas:
- Quantifying (properly describing) perfusion defects
- Report timeliness
- Integrating stress and imaging reports
- Documenting report approval date
Relevance of Report Compliance for IAC Nuclear/PET Accredited Labs
As of March 15th, 2017, IAC Nuclear/PET accreditation requires continuous report scrutiny.
This is because:
- Every 3 years: Reports must be submitted in your application for re-accreditation
- Every 3 years (mid-cycle): Report compliance is audited
- Ongoing Quality Improvement Studies on Report Compliance are required (Standard 1.1.4C)
- The IAC also conducts random audits and site-visits
Thankfully, it is unlikely that minor report non-compliance, in and of itself, would result in a permanent loss of accreditation. The IAC customarily gives a chance to rectify errors.
However it is sometimes the case that accreditation or reaccreditation may be delayed.
- This is significant because reimbursement cannot be collected during accreditation lapses
- Labs cannot retroactively bill even when accreditation is re-established.
- So labs lose the ability to create revenue & scramble to find a suitable reporting solution, which can result in a less than ideal choice.
- Also, in the event of other IAC accreditation problems, it is best not to have report noncompliance as an additional issue. The fewer red flags the better.
- Finally, non-compliant reporting creates ongoing stress for the person responsible for IAC accreditation & puts them in a very awkward position.
Purpose of Our Guide & Checklist
- To provide a clear & meaningful explanation/itemization of the IAC Nuclear/PET report requirements for nuclear cardiology.
- To provide nuclear laboratories with an easy way to assess and improve their compliance with the IAC requirements
- To show how one reporting solution (namely our own) complies with the IAC requirements
How to Use the Guide & Checklist
Our White Paper categorizes the IAC report requirements into 9 sections:
- Facility Information
- Patient Demographics, History & Clinical Indication
- Naming and Description of Procedures
- Stress Test Results
- Imaging Findings
- Impression / Conclusions
- Signature / Report Finalization
- Report Availability /Report Turn-Around Time
- Record Keeping
Each Section Can Be Used as Follows:
Consistently creating IAC Nuclear/PET compliant final reports in an efficient manner presents a real challenge.
Voice Dictation, Text Templates & EHR Templates typically lack sufficient automation for IAC-compliant report generation with a fast report turnaround time. An automated solution built specifically for the task is ideal.
If you’re evaluating nuclear cardiology structured reporting software, do your due diligence, because some commercial applications are not truly compliant.
- Our Guide & Checklist can be used as a clear guide to the IAC reporting requirements
What Do You Think?
What do you think about the IAC Nuclear/PET report requirements? Are they too stringent or do they encourage the right amount of specificity?
Are there any particular challenges your lab faces regarding reports?
I’d love to hear your thoughts- leave your comment below.