If cardiologists, radiologists, and other medical imaging professionals don’t play well in the sandbox together, the federal government will make them do so – or perhaps tear up the sandbox and build something of its own devising.
That’s the message of a recent issue of Health Imaging & IT. Ever-advancing technology may have been the bread and butter of medical imaging a decade ago, but now its cooperation.
What’s changed? The healthcare regulatory environment. The HITECH Act and the Patient Protection and Affordable Care Act gradually put an end to the fee-for-service model of healthcare and replace it with one centered on accountable care organizations (ACOs). ACOs emphasize payment based on healthcare systems that produce desirable patient outcomes, which means that medical imaging professionals that were (more or less) independent brokers of their services now have to think about their service as a part of a whole.
A radiologist’s job, in other words, is moving away from a “provider of radiology services” model and toward a “providing radiology services AND determining how to incorporate radiology into patient care at the lowest cost” model. The same holds true for cardiologists and other medical imaging professionals.
Fortunately, several collaborative models for medical imaging services already exist:
- Ruth Shapiro Cardiovascular Center at Brigham and Women’s Hospital in Boston. Cardiologists and radiologists train side by side, and a patient-centered – as opposed to a procedure-centered – workflow pushes the professional team to use only the medical imaging that is strictly necessary. The institution also recruits specialists with dual appointments in radiology and cardiology.
- Winthrop University Hospital in Mineola, New York. It began its collaborative medical imaging program two years ago, focusing on having all equipment in one location and all patient information available system wide. Financial incentives were also changed to make it more profitable for medical imaging professionals to cooperate.
- Edward Heart Hospital in Naperville, Ill. Any physician who meets credentialing criteria for interventional tasks can perform in the interventional suites, regardless of specialty. In addition, the interventional suite’s quality committee includes radiologists, cardiologists, and surgeons.
- Baptist Cardiac and Vascular Institute in Miami, Florida. It put its cardiac and vascular invasive rooms side by side, separated by glass walls. Medical imaging professionals with different specialties have to work side by side and can easily call on each other for help.
Switching to a collaborative model is anything but easy. As the article states, such an approach “represents a monumental shift in practice models and requires physicians to shed their egos and share the wealth.” Fortunately, the private sector is working hard to make collaboration easier. Most of McKesson’s products, in fact – including its CVIS, PACS, EHRs, Paragon, Enterprise Rx Suite, and even location-specific machines like Anesthesia Rx – are designed to help physicians, medical imaging professionals, and other healthcare workers collaborate more easily.
The alternative to collaboration – i.e. the current system with increased governmental regulation of fees and the inevitable litigation that will follow – makes a shared medical imaging sandbox look attractive indeed.