About 23,000 computerized tomography (CT) and magnetic resonance imaging (MRI) scans administered from January to June were for primary-care patients with relatively mild diagnoses, some of which were possibly unnecessary, the National Health Insurance Administration (NHIA) said yesterday.
The findings were made with the help of artificial intelligence (AI) technology, the agency said.
Of the roughly 781,000 scans that were performed in the period, 3,494 were for headaches, it said.
Superficial injuries and dizziness accounted for 2,442 and 1,978 such tests ordered by doctors respectively, it said, adding that they also ordered scans for diagnoses of osteoarthritis, lower-back and abdominal pain, and coughing.
Of the 140,000 brain CT scans that were performed in the fourth quarter last year, about 40 percent had no direct relationship with a disease, Medical Review and Pharmaceutical Benefits Division inspector Lai Chiu-ling (賴秋伶) said.
These tests might have been ordered by doctors to rule out diseases, as a follow-up to treatment, or were unnecessary, Lai said.
Since the National Health Insurance program was launched, the agency has been collecting nationwide data on medical claims, including 360 million outpatient and 3.44 million inpatient claims per year, she said.
In 2014, the agency began encouraging medical institutions to submit test results and other unstructured, text-based reports, she said.
As of last month, it had received 2.47 billion results, Lai said.
In the past, claims data would be evaluated and inspected by medical professionals to ensure that reasonable payments were being made to medical institutions, but with the advancement of technology, the agency has adopted AI technology to create a natural-language processing system to assist with claims reviews, she said.
The system reduces the time needed to process each claim from four minutes to 0.25 seconds, she said, adding that it is 99 percent accurate.
While the agency respects the professional judgements of doctors, it is also concerned about the possibility of “overly defensive” medicine leading to unnecessary exams, NHIA Director-General Lee Po-chang (李伯璋) said.
To prevent people from being unnecessarily exposed to radiation, the agency is to share data analyzed by AI — including results showing above-average use of the tests — with hospitals to allow administrators to manage and ensure better use of resources, Lee said.
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