Top Doctors 2013: Doing More With Less

Using sonograms to curb expensive MRIs

By Seattle Mag July 25, 2013

This article originally appeared in the July 2013 issue of Seattle magazine.

When orthopedic surgeon Sean Adelman, M.D., served as a member of an Air Force surgical team in the Middle East following 9/11, he didn’t have access to high-end imaging options, such as MRIs. So he and his fellow surgeons used handheld ultrasound devices instead. Years later, this experience would be called on in a different sort of battle—the one against runaway health care costs.

Overuse of expensive imaging is a key factor in the high price of health care. Some national studies estimate at least 15 percent of high-end imaging tests are unnecessary and drive costs higher.

After Dr. Adelman came to Group Health in 2010, he proposed a study of the use of portable ultrasound devices to diagnose certain shoulder injuries. With a grant from the Partnership for Innovation at the Group Health Foundation, which allows providers and staff to test ideas aimed at improving care and lowering costs, Dr. Adelman bought a portable ultrasound machine. As patients came to him with upper arm or shoulder problems, he would decide, based on symptoms, whether to use the ultrasound or MRI, the latter of which can cost around $1,500.

During the 10-month pilot program in 2011, patients avoided 35 MRI exams, and, even factoring in the cost of the ultrasound machine, Group Health saved a minimum of $17,603. This doesn’t include additional savings from eliminating follow-up patient visits to interpret the MRI and plan a course of treatment.

“I’m very pleased,” Dr. Adelman says. “The reality is, conservatively, we’re saving a ton of money. Patients are very appreciative, especially because—when they leave my office—they know what’s going on with their shoulder. They don’t have to wait to schedule a separate MRI.”


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