SVT To Assist in Study Design:
Congress Orders Study of Credentialing
HR 3075, a bill to make corrections in the Medicare and Medicaid programs as revised by the Balanced Budget Act of 1997, as it was passed by Congress, contains language requiring the federal Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality [AHRQ]) to provide for a study to determine the quality of ultrasound services provided by credentialed practitioners as compared to those provided by non-credentialed individuals. Additionally, the AHRQ is instructed to consult with organizations nationally recognized for their expertise in ultrasound procedures.

SVT has contacted AHRQ to advise it of our willingness to discuss the legislation and SVT’s long-held position supporting certification of technologists and laboratory accreditation.

Additionally, SVT has appointed two individuals to a task group to develop a unified statement, to be presented to AHRQ as recommendations for the broad goals of the study. Also represented on this task group are the Society of Diagnostic Medical Sonographers (SDMS) and Cardiovascular Credentialing International (CCI). Both the American Registry of Diagnostic Medical Sonographers (ARDMS) and the American Society of Echocardiography (ASE) have been invited to participate, and information will be shared with them. Plans are for a draft set of recommendations to be prepared and agreed to by the working group. The draft will be presented to ASE and ARDMS in an attempt to secure a consensus among all the groups on any presentation made to AHRQ. We expect developments to move rapidly on this effort; check SVT's web site for breaking news reports.

Frederick A. Anderson, PhD, and J. Dennis Baker, MD, are representing SVT, with support provided by Anne Jones, BSN RN RVT RDMS FSVU, and Frank West, BSN RN RVT CVN FSVU. Representing SDMS are Joan Baker, MSR RDMS RDCS, and Rebecca Hall, PhD RDMS. CCI’s executive director, Julia Hiller, and Norman Fogel, PhD, represent CCI. At press time, the group had met once and agreed that

• The study subsets should be based upon three of the four major ultrasound services: 1) cardiac, 2) vascular, and 3) ob-gyn.
• The simplest study format would be to have credentialed and uncredentialed sonographers perform the same exams on patients with known pathology and compare results.
• Results cannot be simply the written report. It is important to review the sonogram image.
• A set group of reviewers should interpret the studies.
• Focusing on the length of clinical time and the amount of tape acquired would skew the study results inappropriately.
• It would not be helpful to establish volume parameters.
• The study should be conducted on a regional basis in the name of time, money, and efficiency.
• Non-accredited laboratories should be the focus of the study to isolate the effect of accreditation.
• The focus should be on entry level personnel where the effect of credentialing is most significant and to control for confounding factors of experience and years of practice.
• Technologists and sonographers should not be aware that they are involved in a study.
• During the study, it should be determined whether the sonographer or technologist volunteered his or her credentialed/uncredentialed status to the patient.