That’s for sure.

Echocardiography is a cardiac ultrasound that produces 2D or, increasingly, 3D real-time images of a heart. Moreover, an echocardiogram can analyze valve function, blood flow in and out of the heart, “communications” between the left and right sides of the heart, and other cardiac functions.

Electrocardiography, on the other hand, measures the electrical activity of the heart over a period of time.

Both procedures are important in modern-day cardiac care, but echocardiography is increasingly being used in emergency rooms to quickly assess patients experiencing some form of cardiac distress.

Why? For one, echocardiography is easy to perform. Within minutes of admission, a patient can get a highly informative echocardiogram from a cardiac sonographer and start receiving needed treatment (or even surgery) right after that. Electrocardiography, on the other hand, involves a fair amount of set-up time, and the results have to be interpreted without the help of an actual picture of the heart in question.

Also, echocardiography can be used to garner many different types of information. Helpful visual tutorials from the 123sonography.com team (available here) show how easy it is to get an apical 4-chamber view, a subcostal window, and a parasternal window (as well as proving that video education should be a staple in medical education).

Horizon Cardiology’s Echo and Vascular ultrasound streamlines echocardiography technician and physician throughput while facilitating improvement in patient care.

By eliminating VHS tapes and paper, the system – which is part of McKesson’s comprehensive CVIS – enables echocardiography technicians and doctors to easily access patient information (including other medical images), and it makes reporting results as simple as a click of a mouse.

To receive the latest echocardiography and other medical imaging news, subscribe to the Medical Imaging Talk blog via RSS feed or email. Or follow us on Twitter.

• Liver cancer treatment. Interventional radiologists may have discovered a way to better identify and modify blood vessels so that radiation-emitting – and cancer killing – beads can be delivered to inoperable liver tumors. Continue reading.
• Stress and sleep studies. Neuroimaging has been used to study all kinds of things, but not the effect of stress and sleep deprivation. Scientists in Virginia hope to better understand how the brainstem and thalamus by recording the effects of stress and sleeplessness. Continue reading.
• Fiber optic illumination. New technology enables huge amounts of photons to illuminate targets inside the body, helping surgeons and other professionals to use smaller cameras (and other medical imaging equipment) while still seeing a sharp picture. Continue reading.
• Optical frequency data imaging. Advances in this technology are getting medical imaging professionals closer to comprehensive, volumetric images of esophageal tissue in less than 60 seconds. Continue reading.
• Alzheimer’s education. It’s not a technological advance, but an educational one. Several radiologists worked together to produce a digital e-booklet on Alzheimer’s which included several MRI, CT, and ultrasound images. Continue reading.
• Breast cancer treatment. Researchers in Florida have developed an infrared excitable dye, detectable by MRI and other medical imaging technology that will indicate where otherwise hard-to-detect breast micrometastases are. Continue reading.
•  Bladder cancer treatment. A small number of medical facilities across the country are beginning to use a new optical imaging agent that should increase detection of bladder cancer. Continue reading.

Subscribe to this blog for more updates on medical imaging technology and medical imaging news.

The other reason medical professionals look forward to RSNA is to learn about the economics that drive the industry. ACO’s, meaningful use, teleradiology, commoditization – these are all changing the medical imaging market, and professionals in the field should know how they may define the role of the medical imaging professional in the future.

If you’re interested in the economics of medical imaging, we suggest you think about attending the following sessions:

• Special Lecture: Year Two of Health System Reform—Where Are We Now? Arie Crown Theater, Monday, Nov. 28, 1:30 – 2:45 PM. Get an update on the impact of healthcare reform on the economics of the healthcare industry from Peter Carmel, MD, President of the AMA.
• How Payment Policy Will Impact Technology Development in the 21st Century: An ACR Interactive Session. S404AB, Tuesday, November 29, 4:30-6:00 PM. Learn “about the current process of how reimbursement for new technology and procedures is obtained and consider strategic partnerships between industry, researchers, governmental agencies and third party payors in order to optimize the process in the future.”
• Monetary Decisions in Radiology Practice: Valuing Your Practice, Assessing Future Financial Trends, and Optimizing Personal Finance. S403A, Thursday, Dec. 1, 8:30 – 10:00 AM. Learn about key market trends, valuing services, growing a business, wealth management, and other topics from a panel of experts in healthcare economics.
• Health Policy and Economics. LL-PPE1021, Lakeside Learning Center, every day.  Actually, it’s an exhibit, not a presentation. But it’s hosted by noted healthcare economist James Vincent Rawson, who also happens to be a radiologist.

Pre-book an RSNA demo with McKesson online or visit booth #211 Lakeside Center.

Can’t go to RSNA? Register to attend the RSNA Virtual Conference and explore a virtual world complete with educational offerings. Attend sessions and be sure to visit the McKesson Showcase on your own time, from anywhere in the world.

This blog post includes information from a recent article in HealthImaging.com

In the meantime, though, it’s best to proceed as if PPACA will be implemented as planned. For hospitals and healthcare organizations with radiology systems, that means that this article from Diagnostic Imaging is probably worth reading.

The article reports on the words of Robert Still, a doctor and practice manager at Lancaster Radiology Associates in Auburn, Pennsylvania. Still recently spoke at the AHRA’s annual meeting in Dallas.

According to Still, the healthcare system will change dramatically in the next few years because of PPACA. The biggest change will be in reimbursement methods. Instead of the old (and familiar) fee-for service system, a “bundled” payment structure will predominate. For radiologists and other medical imaging professionals, this probably means a cutback in radiologist reimbursement. And that, in turn, probably means an end to solo and small radiology practices.

A cutback in demand for images is another likely consequence of the shift in reimbursement systems, according to Still. Because of their costs, images will have to be pre-authorized by non-radiologists, and that almost surely means fewer images ordered.

Still also notes present and future trouble with meaningful use compliance. In order to qualify for reimbursement (or, after 2015, avoid a penalty), physicians have to spend a certain amount of time at one facility. Radiologists, who often divide their time between hospitals and clinics, are often left out of reimbursement schemes. Still hopes that officials at CMS will expand their reimbursement qualifications so that more radiologists see the money they deserve.

One thing is for sure, says Still: the practice of radiology will change to accommodate the need for more efficiency and lower costs.

For more information about radiology systems, contact us.

• Pre-Loaded and Customizable Tables. No one in a radiology department has time to create all the tables the department needs, which is why an RIS should come with the most common tables pre-loaded. But it should also allow the department to easily manipulate basic templates to meet its unique needs. 
  

• Comprehensive Workflow Coverage. Scheduling, ordering, dictation, charge preparation, and so on: A top-of-the-line RIS will take all of these workflow functions into consideration – and maybe even include some that are easy to overlook.

• Full integration with a PACS. If a radiology department’s PACS and an RIS can’t talk to each other, someone – or a lot of people – will have to spend a lot of hours transferring data from one to the other.

• Integration with an EMR. The push for more and better integration of healthcare services will only get stronger in the coming months and years.

• Quick Installation. 12 weeks – that’s the longest it should take to install an RIS system and train people to use it. Smaller practices can expect an even faster installation.

• Substantial Return on Investment. Buying or upgrading a RIS demands significant capital. But the right RIS improves efficiency, reduces overhead costs, and allows a radiology department to expand its customer base.

Whether you’re replacing your current RIS, switching to an enterprise-wide solution or investigating RIS for the first time, it makes financial sense to partner with a vendor who can provide a dependable, profitable solution for your facility.

Schedule a demo to learn more about working McKesson’s RIS or contact us directly for more information. You can also look for us at Booth #211 Lakeside Center at the upcoming RSNA 2011.

Copeland is the CEO at Inland Imaging in Spokane, Washington, which provides radiology services to regional healthcare practices. Specifically, he is responsible for assembling specialists who provide consulting services to a variety of private and public clients.

By 2006, Inland Imaging employed 65 radiologists, was completely filmless, used voice-recognition software, and had a single PACS database with connections to the Radiology Information System (RIS) of six vendors.

But, notes Copeland, they “had only gross estimates of the day and night demands on workflow, and we had no accurate work RVU reporting due to data being fragmented across multiple systems.” Why? The PACS and RIS systems, although huge improvements over the previous radiology technology, still did not track all necessary items such as exam backlogs and turnaround reporting time.

After brainstorming, planning, and four developers working for two years, a new workflow system was launched. It was used by everyone in all branches of the practice – specialists, sub-specialists, assistants, even dispatchers.

In fact, the dispatchers immediately started using the information the new system gave them to assign outstanding work to properly credentialed radiology professionals who were available at a given time.

The results have been good for Inland Imaging. Productivity has gone up 14%, peer review of radiology images has increased, and reporting functions help administrators (and other users) know where quality and efficiency can be improved. Moreover, the radiology professionals at Inland Imaging are happy with the new system because it gives them more time with images by making radiology administration easier.

Copeland stresses that workflow issues aren’t over. But their new system gives them the ability to continually measure and improve workflow – a task, notes Copeland that is absolutely necessary in today’s competitive radiology marketplace.

Click here to read Copeland’s original article for Radiology Business Journal.

Follow more current topics in radiology by subscribing to this blog. You can also follow McKesson Medical Imaging on Twitter and Facebook.

According to HIMSS Analytics, hospital IT budgets may get back to pre-recession levels sooner rather than later.

The report, which is good news for healthcare IT companies like McKesson, is based on first quarter reports of over 5200 hospitals. The two key details:

• The adoption of EMRs and EMR-related applications increased from 2009 to 2010,  No doubt because of the drive to meet “meaningful use” criteria. According to John P. Hoyt, executive vice president of organizational services at HIMSS, “The number of hospitals reaching Stage 6 of the HIMSS Analytics EMR Adoption Model doubled last year.”
• Spending on data warehousing and business intelligence systems increased from 2009 to 2010.

The HIMSS Analytics report projects that 1) Spending on revenue cycle management will increase in the next five years, 2) Capital spending for IT applications will constitute 46.5 to 48.3 of total IT capital budgets in 2011, and 3) Healthcare IT application purchases will grow at a rate of five percent or greater in the next 5 years.

According to HIMSS, the big stimulus for all this healthcare IT spending is the stimulus package, also known as the American Recovery and Reinvestment Act (ARRA), which accelerated the adoption of EMRs and other healthcare IT with its “meaningful use” stipulations and its cash awards to qualifying institutions.

The smaller driver of increased spending on IT is simple necessity. In particular, more unfunded mandates and payment reductions will force hospitals to better manage their capital via improved revenue cycle management applications.

Subscribe to this blog for regular updates on the world of medical imaging.

That dollar amount is based on substantial data. The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) analyzed around 9.6 million claims before concluding that 19 percent of outpatient CTs and MRIs and 14 percent of outpatient x-rays at Emergency Departments (EDs) around the country were improperly documented.

The two most common documentation errors were 1) A lack of a physician’s order for the medical imaging and 2) Analysis of medical imaging after the patient had left the ED.

What’s not clear is how many of those medical images would still have been approved for payment if the documentation had been proper.

OIG basically concluded that the problem – and therefore the solution – is two-pronged:

• EDs have to improve their documentation procedures. This is not a mere technicality. A physician’s approval indicates that a trained medical professional thinks that some kind of medical imaging would be beneficial. Medical imaging is expensive, so it shouldn’t be used  haphazardly.
• CMS needs to clarify its medical imaging interpretation rules. It turns out that many EDs have been interpreting images after patients leave for some time and that CMS hasn’t let that be a barrier to payment. The reasons for “delayed interpretation” are many: patients who aren’t in serious condition leave the ED and are willing to wait at home for medical imaging results, EDs are understaffed, radiologists and other medical imaging professionals are not as available during the hours when EDs are busiest, and so on.

CMS accepted the OIG’s recommendation that it clarify ED medical imaging documentation requirements. We’ll see if healthcare systems improve their own internal procedures to prevent unnecessary medical imaging and ensure proper documentation of medical imaging procedures.

Learn more about McKesson Medical Imaging solutions that improve the communication between the emergency department and radiology

A fact we’ve mentioned on this blog time and time again is that medical IT technology is ever-evolving and constantly updating.  The appearance of new technology in any hospital, clinic or private practice can mean that the training for associates is often lacking.  When that training falls short of excellent, problems can arise and discrepancies can start to pop up that may be extremely dangerous and costly.  Now, the American Society of Echocardiography is saying that training needs to increase for these costly mistakes and discrepancies to finally disappear.

When the ASE conducted their own research and reports, their findings were disturbing.  After looking through over 14,000 transthoracic echocardiograms (TTE), almost 2,000 transesophageal echocardiograms (TEE) and over 2,000 stress echocardiograms (SE), they came up with a percentage of discrepancy.  The scary thing was, 29% of the reports had major discrepancies that came during evaluation by Level 2 echo readers, not the higher Level 3.  That means, almost 1 in 3 echocardiograms were incorrectly read or found costly and dangerous discrepancies.

Most of the discrepancies that popped up during evaluation lead to further testing.  Here is what the ASE found:

“During the study, the most common discrepancy pertained to the diagnosis of patent foramen ovale and atrial septal defect by TTE (18 patients). The researchers said that these discrepancies often led to further testing via TEE…Other major discrepancies occurred during cardiac coronary angiography where there was a 40 percent discrepancy rate in the diagnosis of aortic valve disease. During TEE, mitral valve disease diagnosis discrepancies occurred in 37.5 percent of patients and 100 percent during the diagnosis of cardiac masses (six of six patients)…Major discrepancies of stress echocardiographs occurred in all five patients who underwent coronary angiography.”

Clearly, as medical imaging technology leaps forward, so too must the training as to exactly how to use, evaluate and apply the knowledge the new technology provides.  Without proper education and training, the highest technology is still susceptible to human error.

To read more about the discrepancies being found in echocardiography according to the ASE, feel free to check out the full article.

For all the latest radiology and medical imaging technology news, subscribe now to the Medical Imaging Talk blog via RSS feed or email. Or follow us on Twitter today.

Each year, the top 20 companies in the medical equipment world are chosen to be part of a Best in KLAS award that recognizes those who go above and beyond.  Once again, and impressively so, Toshiba America Medical Systems continues to stand out when it comes to their service and support for its customers.  They have taken home the number 1 top spot as the best medical equipment vendor of the year.  This marks the 3^rd straight year they have done so, and even more impressively, they hold the top spot in 5 different categories.

The annual report ranks medical imaging equipment vendors in 8 key market categories that include CT, digital mammography, MRI, digital x-ray and ultrasound.  While Toshiba has consistently been in the top, there has not been a great deal of movement or changing of guards below them.

As mentioned, Toshiba, a McKesson Medical Imaging Partner, took the top ranking overall while staying extremely solid in the CT and MR segments this year.  The best news, however, is that the Best in KLAS report comes from over 2,000 interviews done every month with hospitals and providers.  They rank the equipment on 25 different dimensions and the results them form the list.  This means that Toshiba is held in extremely high regard by those who actually use it on a daily basis.

To read more about this, check out the Best in KLAS report and article.

For all the latest radiology, cardiology and medical imaging technology news, subscribe now to the Medical Imaging Talk blog via RSS feed or email. Or follow us on Twitter today.