Radiologists face commoditization as population health management demands innovation across the care continuum unless they become more involved in patient-centered care. The editors of ImagingBiz focused on four issues that shaped medical imaging last year and demonstrate how radiology departments and radiologists are adapting to new technology, regulation and business risk in ways that allow them to continue to provide high-quality care.
1. Is there a future-proof approach to implementing enterprise imaging?
McKesson customer Methodist Le Bonheur Healthcare (MLH), a Memphis, Tennessee-based health care system of eight hospitals, found both its general PACS and cardiology PACS aging past viability at the same time, raising an interesting question: Was the organization prepared to explore an integrated enterprise medical imaging platform and vendor-neutral archive (VNA)?
The problem was one familiar to most health IT professionals: reconciling the needs and demands of separate clinical silos to find a solution that would work equally well for everyone. The transition often represents a philosophical and strategic change as much as it does an architectural one.
“It was going to be challenging enlisting all the users who saw their needs, from the clinical and service perspectives, as being greater than the enterprise needs,” said Alastair MacGregor, MB ChB, chief health information officer at MLH to ImagingBiz editor, Cat Vasko. “We didn’t know if there was a vendor that could meet everyone’s functional requirements.”
As evidence, he pointed to the announcement that McKesson, Cerner, Allscripts, Greenway, RelayHealth, and athenahealth would join together in an alliance aimed at creating seamless interoperability between their respective health IT platforms. “The vendors are going to do this, and find a way to do it at a very low cost,” MacGregor said. “They claim they feel a moral obligation to make health information interoperable. Our strategy will continue to evolve as the marketplace evolves.”
2. As health IT becomes increasingly mobile, what are the key challenges facing radiology departments?
While the primary advantages of mobile health IT is flexibility and efficiency, it raises a lot of questions about device management and ownership. If devices are physician-owned, they are potentially vulnerable to third-party applications. When devices are hospital-owned, they can control the applications’ content and accessibility, which gives them better control over the management and health of the devices.
McKesson’s fully web-based, comprehensive RIS/PACS solution helps organizations assume ownership and control of their IT investment to best serve the clinicians who use these solutions. Options are available to fulfill specific workflow requirements in and around the facility or even beyond its walls, connecting to today’s leading-edge mobile technology.
“Planning and preparation for any contingency are key, and the best way to approach that is to think about what the right device is for the task. Make sure to set aside enough time to evaluate the major devices—you may be surprised which one fits the needs of your organization best,” advised Freddie Adorno, enterprise imaging informatics manager at Nyack Hospital, Nyack, New York.
3. When radiologists extend connectivity to referrers, what are they risking?
“While it may make good business sense for an imaging center or radiology practice to provide and pay for software upgrades necessary for the RIS/PACS to interface with the EHR in the ordering physician’s office, these types of arrangements can raise significant regulatory issues,” wrote authors, Thomas W. Greeson, JD, and Paul Pitts, JD, in their ImagingBiz article.
Federal and state laws prohibit radiologists and imaging centers from offering referring physicians something of value in return for ordering diagnostic tests.
Regardless of what may be permitted under the Stark law, radiologists and imaging centers should consider limiting their share of the total cost involved in installing and maintaining a software interface or other IT systems because the arrangement would still be subject to scrutiny under the federal anti-kickback statute and unlikely to fit within a safe harbor, Greeson and Pitts concluded.
4. How can teleradiology programs be extended to work on a national level?
It’s a new day and a new VA, according to Colleen Passmore, administrative officer with the Veteran’s Health Administration National Teleradiology (NTP) Program in San Bruno, California. Who better to be the poster child of extending teleradiology on a national level than a behemoth their size?
The program has been such a success that it has nearly doubled in size every year since it began providing services in 2009. Passmore reports that the NTP expects to be serving 22 additional facilities by the end of this year, close to half of the VA health system.
The NTP’s strong focus on quality assurance and the fact that NTP radiologists have national privileges within the VA (by an arrangement made with The Joint Commission) is another reason the program enjoys such great success.
Radiology’s value proposition hinges both on its ability to deliver the best possible product and on its willingness to assume new responsibilities. Success in both components will help improve care and control costs—the primary goals of the Accountable Care Act.
What issue does your organization see shaping the future of medical imaging technology? Please feel free to comment or subscribe to our blog to keep reading more stories like this one.