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Lack of strategies to manage MRI wait lists a key reason for excessive wait times

A new study headed by Dr. Tom Feasby, Dean of UCalgary's Faculty of Medicine, shows that while Canada lags behind other countries in the number of diagnostic imaging devices, more machines are not the only solution to long wait times. The study's authors say it is critical to prioritize MRI (magnetic resonance imaging) requests effectively.

"This study shows there are important deficiencies in the current system. We hope this research will help health system decision-makers and managers improve the provision of this important service," says Feasby, the senior author of "Management of MRI Wait Lists in Canada," published in Healthcare Policy.

A MRI provides detailed images of the body, and is technology that is being used more frequently, especially in the areas of abdominal, pelvic, cardiac and breast imaging. The technology can be used to evaluate tumours, show abnormalities in the heart, brain and joints.

To determine how requests for MRI studies are managed the study's authors surveyed public MRI facilities in Canada. Although almost all of the facilities have some methods to triage MRI requests, less than half documented their guidelines for prioritization, and none used quality assurance methods to ensure guidelines were followed. The report determined that despite wait times of up to several years in some facilities, strategies to reduce wait times are diverse, uncoordinated and largely ineffective.

Dr. Derek Emery, one of the report's authors, says, "most MRI facilities in Canada have a substantial wait list problem. Improvement in wait list management will be necessary for better access, fairness and quality in the provision of MRI services in Canada. We do not currently know the extent of inappropriate overuse of MRI, nor do we know the extent of inappropriate underuse." Emery is an Associate Professor in the Department of Radiology and Diagnostic Imaging at the University of Alberta.

"This paper shows that many MRI centres do not employ effective and standardized processes to track and manage the appropriateness of the scans they perform. Such processes are crucial to ensure that patients in different regions of Canada have equitable access to MRIs, and that patients who really do need an MRI get one rapidly. This is a challenging problem, and needs the focused attention not only of radiologists, but particularly the physicians who are ordering the scans," says Dr. Andreas Laupacis, a general internist, the Executive Director of the Li Ka Shing Knowledge Institute at St. Michael's Hospital in Toronto, and a professor in the Departments of Medicine and Health Policy Management and Evaluation at the University of Toronto.

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