Mining the Value from Radiology Innovations



More than just new toys, new imaging technologies can help radiologists drive value-based care

Ask any of the nearly 49,000 registered attendees of this week’s RSNA Scientific Assembly and Annual Meeting in Chicago for one word that dominated the conversation during the first three days of the conference, and I would bet that word would be “value.”

As the industry transitions from one based on fee-for-service medicine to one dominated by value-based reimbursement models, the question threading through conversations from plenary session presenters to conversations at the coffee stand on the exhibit floor is this: How can radiologists drive more value out of the patient care experience? And they’re asking that question while surrounded by millions of dollars’ worth of the latest diagnostic imaging equipment available from around the world.

In his opening address on Sunday, RSNA President Richard Baron, M.D., answered the question—and raised a lot of eyebrows—by challenging radiologists to “get back to basics” by focusing on what’s best for the patient rather than on what’s most convenient, efficient or lucrative for themselves. He’s right. In the old fee-for-service model, the value of radiology was measured by throughput. This many imaging procedures were good. This many were bad. And this many were very good.

Today, value is measured by better clinical outcomes at less cost. In that equation, throughput becomes less important and the quality of the imaging procedure becomes more important. By that I mean not just reading the image correctly and sending it to the treating physician. I mean integrating clinical data from the patient’s EMR into the imaging process and looking for things based on that clinical data that may not have been initially ordered. I mean including in the radiology report not just what was found but an interpretation of what was found along with treatment recommendations or recommendations for further diagnostic imaging tests based on that interpretation. That approach by radiologists will lead to better clinical outcomes and drive greater value.

I believe new technologies that connect imaging to other patient information systems will more than pay for themselves from the savings generated by improved clinical outcomes driven by earlier and more effective clinical interventions.

As Keith Dreyer, D.O., noted in his presentation during the opening plenary session, machine learning, or artificial intelligence, will become a tremendous asset to radiologists as they adapt to this new value-driven approach to what they do. Dreyer, who is vice chairman of radiology computing and information services at Massachusetts General Hospital in Boston, said radiologists will be able to use AI in screening technologies to detect diseases by synthesizing aggregate and patient-specific clinical data from all sources to produce what he called “precision radiology reports.” It may take some time for Dr. Dreyer’s vision to become a reality, but when it does, it will augment and greatly assist radiologists in driving more value from imaging procedures.

The other piece of the value equation is cost. As Vivian Lee, M.D., CEO of University of Utah Health Care in Salt Lake City, estimated in her presentation during Monday’s plenary session at RSNA, as much as 80 percent of the cost of an imaging procedure is labor-related. That’s primarily the cost of the technician taking the image and the cost of the radiologist reading the image. Technologies that can automate and streamline imaging workflows of technicians and radiologists can reduce those labor costs and lead to less expensive imaging procedures without sacrificing quality. That’s the definition of value.

Other technologies targeted at imaging workflows can mine even more from both the quality and cost pieces of the value equation. Such technologies can prompt workflow interactions between radiologists and other clinicians like emergency room doctors and referring physicians for patient safety checks and discrepancy and critical results management functions. Think of these as “digital hallways” that replace the physical meeting rooms where radiologists and other clinicians consult on patient care.

By focusing on the patient and using technological advances to improve care and lower costs, radiologists can become the leading drivers of value in today’s health care delivery system.

Ashish Sant is general manager for radiology for Change Healthcare’s Imaging and Workflow Solutions business unit. 

Visit Change Healthcare at RSNA 2016 at Booth #7310 in the North Hall at Chicago’s McCormick Place.

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