Last week at the annual meeting of the RSNA (Radiological Society of North America), thousands of radiology leaders from around the world descended upon Chicago searching for ways their profession can deliver more value to health systems and the patients they serve. With radiology’s transition from a profit center to a cost center for hospitals, the status quo is no longer good enough when it comes to medical imaging. Radiologists must up their game when it comes to quality, cost efficiency and collaboration to extend their value throughout the care continuum.
This universal tone was encapsulated nicely during Monday’s Plenary Session Oration titled Healthcare Transformation: Driving Value Through Imaging, which was delivered by Dr. Vivian S. Lee, CEO of University of Utah Health Care. According to Lee, “value” in healthcare is providing the best care at the lowest cost. During her presentation, she shared a simple equation her organization uses to measure this often intangible attribute — Value = Quality + Service / Cost.
There are several ways University of Utah Health Care applies this equation throughout its enterprise. For example, it tabulates ED, OR, Surgical, ICU and Floor costs for a variety of procedures and compares these figures against patient satisfaction scores to determine cost-to-quality ratios for specific procedures and providers. However, the main point Lee made was there are numerous ways radiology can positively impact this value equation on a day-to-day basis, and almost all of them involve leveraging health IT in new and innovative ways.
For example, Lee pointed out that more than 80 percent of medical imaging costs are tied to labor (Interpretation – 40.1% and Personnel – 39.6%). Using data analytics and process intelligence tools to identify ways to reduce the amount of time this expensive labor is needed can cut the costs of imaging dramatically. These tools can similarly be applied to identify roadblocks in the delivery of imaging studies, helping to accelerate reporting which is an important aspect of a radiology service to both a referring physician and the patient.
However, Lee believes the primary means by which radiologists can drive value is by enabling earlier, more accurate, diagnosis and reducing misdiagnosis. Since diagnostic errors are more costly than treatment mistakes, improving performance in this area can have a cumulative effect on overall value. Therefore, the most important health IT investments for radiology are those that support diagnostic processes.
Investing in newer, more precise, imaging techniques, such as molecular imaging, is one way to improve diagnostic quality. For example, these methods can help better match patients to specific drug treatments or dosages based on their specific molecular makeup, reducing the administration of expensive pharmaceuticals.
However, improving diagnostic quality need not rely on next-generation imaging equipment or procedures. An immediate, measurable impact can be made simply by getting the all the relevant imaging-related information that exists throughout the enterprise into the hands of the clinicians responsible for diagnosing and treating patients.
All too often medical images are stored in silos — whether it’s a radiology PACS/RIS system, a fluoroscopic imaging system, or a pathology imaging system. The clinician caring for the patient rarely has easy access to all of the patient images stored in these various systems. In fact, there’s a high likelihood the clinician doesn’t even know many of these images exist. Making diagnosis and treatment decisions based on incomplete information is a key contributor to misdiagnosis, patient dissatisfaction and higher care costs. Taking an Enterprise Imaging approach that leverages VNA (Vendor Neutral Archive), image connectivity and enterprise viewing technologies eliminates vendor lock-and-block and makes these images accessible from core clinical systems. Employing an Enterprise Imaging strategy that truly puts all images at a clinician’s fingertips can go a long way toward improving patient outcomes and radiology’s overall value.
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