Use of in-network insurance benefits is critical for improving retention in telehealth-based buprenorphine treatment.

An empiric evidence base is lacking regarding the relationship between insurance status, payment source, and outcomes among patients with opioid use disorder (OUD) on telehealth platforms. Such information gaps may lead to unintended impacts of policy changes. Following the phase-out of the COVID-19 Public Health Emergency, states were allowed to redetermine Medicaid eligibility and disenroll individuals. Yet, financial barriers remain a common and significant hurdle for patients with OUD and are associated with worse outcomes. We studied 3842 patients entering care in 2022 at Ophelia Health, one of the nation's largest OUD telehealth companies, to assess associations between insurance status and 6-month retention. In multivariable analyses, in-network patients who could use insurance benefits were more likely to be retained compared with cash-pay patients (adjusted risk ratio [aRR]: 1.50; 95% CI: 1.40-1.62; P < .001). Among a subsample of 882 patients for whom more detailed insurance data were available (due to phased-in electronic health record updates), in-network patients were also more likely to be retained at 6 months compared with insured, yet out-of-network patients (aRR: 1.86; 95% CI: 1.54-2.23; P < .001). Findings show that insurance status, and specifically the use of in-network benefits, is associated with superior retention and suggest that Medicaid disenrollment and insurance plan hesitation to engage with telehealth providers may undermine the nation's response to the opioid crisis.

Radiologic Sciences Student Perceptions of Advisement.

PURPOSE: To investigate student perceptions of a structured advisement program. METHODS: Using a mixed-methods approach, 24 radiologic sciences students were surveyed in the initial and final semesters of the program to capture their perceptions of advisement practices. Quantitative data were analyzed for percentages and descriptive statistics, and qualitative responses were analyzed for emergent themes. RESULTS: Qualitative data analyses identified 3 themes: building relationships, strengthening student performance, and determining best practices for advisement. Quantitative data demonstrated that students appreciated the advisement process and acknowledged improvements in communication skills and the feedback loop. DISCUSSION: Advisement sessions can serve an important role in identifying areas where students can improve their performance. To grow and develop, students must understand their own strengths and weaknesses. Structured forms of advisement can serve as important tools to guide advisement conversations toward specific topics. CONCLUSION: The results of this study indicate that student advising is a vital component of radiologic sciences programs. Participants indicated that the advisement process helped them build relationships with faculty members and improved their overall performance.

Imaging Advancements in Nuclear Medicine: Pancreatic Neuroendocrine Tumor Localization and Treatment.

BACKGROUND: This case report details a 57-year-old African American man with pancreatic neuroendocrine tumors (NETs). The patient underwent positron emission tomography (PET) imaging using gallium Ga 68 dotatate, which localized the tumors. Selected tumors were treated with 4 doses of 200 mCi of lutetium Lu 177 dotatate during a period of 8 months. At the conclusion of treatment, the patient demonstrated improvement, progressing from bedbound and confused to ambulatory and coherent. In addition, the patient stated he felt no adverse effects. DISCUSSION: Pancreatic NETs are rare tumors affecting 0.001% of the population. These tumors are associated with various symptoms and are classified as functional or nonfunctional. Imaging modalities, such as computed tomography (CT), magnetic resonance (MR) imaging, and gallium Ga 68-labeled PET, are essential in detecting and evaluating pancreatic NETs. For patients with localized NETs, the primary treatment is surgery; however, the radiopharmaceuticals yttrium Y 90 microspheres and lutetium Lu 177 dotatate are used as therapy to treat nonresectable tumors. CONCLUSION: Lutetium Lu 177 dotatate is used in NET cases that are deemed inoperable and for patients who are not responding to treatment. This case study demonstrates the effectiveness of combining imaging with Ga 68-labeled PET and treatment with lutetium Lu 177 dotatate. This treatment is not a cure but has been shown to improve a patient's quality of life.

Safety Resources and Processes in MR Imaging Departments.

PURPOSE: To identify current standards of safety practices, common safety resources in use, and gaps in workflow practices in magnetic resonance (MR) imaging departments. METHODS: Qualitative observational research and visual assessments of safety resources available at clinical rotation sites were conducted with subsequent open coding analysis. RESULTS: The sample varied in terms of the strength of MR systems, types of facilities, patient populations, and safety resources available. Qualitative themes included carelessness of personnel, facility design flaws, and inconsistencies in safety practices and staffing. DISCUSSION: Proper screening of patients and other individuals, appropriate use of barriers, and ferromagnetic detection systems can be effective tools for ensuring patient and personnel safety. Although various safety resources were available at most MR imaging facilities, the resources proved to be only as effective as the safety practices of the MR technologists. CONCLUSION: Safety practices in MR imaging departments can be improved upon continually. This study provides a foundation for future research on MR safety practices.