Employing computed tomography (CT) scans has both advantages and risks. CT has led to revolutionary enhancements in the diagnosis and treatment of many diseases, as well as nearly ending the need for exploratory surgery and many other invasive procedures. The risk involved is that a CT scan delivers 70 times as much radiation as a chest x-ray.
Measuring Lifetime Health Risk
Networking and privacy issues are top concerns for managing imaging data in the cloud, which was a topic addressed at the recent RNSA conference. According to Fred Prior, PhD, of Washington University in St. Louis, cloud computing can offer many advantages to medical imaging, but effective project management is crucial to realize any cost savings.
Is the Cloud Implying a False Sense of Security?
Placing the word “cloud” into a computing technology gives the uninitiated a false sense of unlimited space and infallible security. Well, not all networks are created equal. For teaching hospitals affiliated with a university, radiologists are most likely spoiled by the easy access to a high-speed university network. The assumption is that they can push medical images to the “cloud” quickly and with little thought.
Medical imaging systems have continually represented – or helped us to take advantage of – the cutting-edge of healthcare information technology. Here’s a quick look at some of the industry trends these systems will help our field to benefit from through the balance of the year.
1. Mobile Devices. The 2nd Annual HIMSS Mobile Technology Survey published in December 2012 (available for download here) identified an increased use of mobile devices by medical professionals. Meanwhile, a Manhattan Research survey found that 62 percent of physicians used mobile devices in their daily practice last year, double the use from 2011. While 2010 may have been hot for the smartphone, in 2012 use of the media tablet heated up. Expect this trend to grow throughout the year, with goals rooted in more efficient patient care.
Earlier this week, emergency medicine specialist Dr. Sandra Schneider identified emergency department overcrowding as a symptom of hospital overcrowding in part one of my interview with her. In part two yesterday, we identified better collaboration between medical imaging and emergency care leaders as critical towards managing overcrowding.
In the final part of my interview below, we put our focus squarely on the patient, as we learn how all of medicine must work together to improve the cost efficiency of care, without sacrificing improvements to patient outcomes.
How do you see the new focus on improving patient outcomes impacting emergency medical care and/or reimbursements?
In part one of my interview with Dr. Sandra Schneider, we identified emergency department overcrowding as a symptom – rather than cause of – overall hospital overcrowding, while dispelling some long held myths regarding the true economic impact of this issue.
While yesterday’s interview provided more context, the fact remains that emergency department overcrowding is an issue all the same. And with the roll-out of health care reform, many expect it to continue to grow in severity.
Over the last several years, emergency department overcrowding has become a troubling issue, one that can become an easy scapegoat for the massive health care cost overruns we have become accustomed to hearing about.
But is emergency department overcrowding a cause – or a symptom – of something larger? And whether emergency department overcrowding is a cause or a symptom, how can healthcare organizations use new technology, including medical imaging, as a cure?
One of radiology’s biggest thinkers, University of Chicago School of Medicine vice-chair of radiology informatics, Paul Chang, MD, wants radiologists to step up their game. Meaningful use requirements dictate the adoption of business intelligence analytics (BIA) for radiology. And you can’t improve what you don’t measure.
Measuring Efficiency Using Key Performance Indicators (KPIs)
According to Chang, radiology lags way behind other business models in the use of BIA, which includes dashboards, scorecards and other key performance indicators (KPIs). A KPI helps measure if you’re improving your processes, efficiencies and adding value to the product or service you provide.
“A complex system that works is invariably found to have evolved from a simple system that worked.”|
John Gall, The Systems Bible
Gall’s quote above can be very readily applied to meeting the needs of multi-facility hospitals and health care organizations, particularly, the needs of the medical imaging department. Some of the more common challenges with managing medical imaging across multiple facilities include:
- Radiologist travel needs
- Slow report turnaround times
- Disparate systems containing incomplete patient information
And it was this last challenge in particular, coupled with over 1,100 medical imaging system installations, that helped to drive the development of the newest enterprise medical imaging solutions from McKesson.
There’s no shortage of commentary on what the consequences of changing from a fee-for-service model to value-based reimbursement might have on healthcare delivery and profits, but an article by two authors, cited by Health Imaging, caught our attention with a provocative premise: develop a reimbursement metric that focuses on physician time savings.
Christoph I. Lee, MD, of the Robert Wood Johnson Clinical Scholars Program at University of California, Los Angeles (UCLA), and Dieter R. Enzmann, MD, of the David Geffen School of Medicine at UCLA, suggest that radiologists will benefit in this new era if they focus on the time value of money rather than radiology information systems imaging technology. You can read the abstract of their article here.
In the business world, “gatekeeper” has come to be known as the person who controls access to the decision maker. In medicine, a primary care physician monitors a patient’s health care and serves as gatekeeper for HMO services. If you’re a radiologist reading this, it’s likely that you’ve never considered yourself a gatekeeper of anything.
But, Alan Kaye, MD, recommended utilizing imaging gatekeeping as a means to hinder the increasing commoditization of medical imaging in his session presented at the annual meeting of the Radiological Society of North America (RSNA).
“Gatekeeping” Benefits Patients