Facility Management

Of all the things uttered by President Clinton, the best remembered may be his questioning of what “‘is” is, an ignominious line prompted by an investigation that led eventually to his impeachment. Today that question can be legitimately asked with only a change in capitalization and pronunciation as the information technology world questions the significance of IS (information systems).

Automation is the grease that makes workflow glide. Single clicks and macros are lesser elements of this process. The real gains are made under the covers of IT systems by algorithms with preprogrammed agenda. Far more intelligent tools than these will soon be needed to handle the wave of EMRs gathering off the shores of U.S. healthcare.

GE strikes hospital alliance to develop connectivity SonoSite 1Q revenues look likely to slip

RIS and PACS vendors saw it coming a long time ago, a need to make data repositories work with IT the systems that drive workflow. The hybridization of RIS and PACS, preceded by interfaces that allowed the transfer of data between and among systems by different vendors, blazed a trail toward interoperability. This trail has now fanning out to super highway status to accommodate the spread of companies seeking to provide answers to IT questions that must be answered if the Obama initiative is to improve the efficiency of U.S. healthcare.

You’d think that a society such as ours, one steeped in the Internet and awash in cell phones and iPods, would gravitate toward electronic health records. But, in what has been framed as the first nationally representative study of EHR prevalence in hospitals, researchers in Boston and Washington, DC, found that less than 2% of U.S. hospitals have so far implemented comprehensive EHRs. Less than 8% have even basic EHRs in place.

Economic issues beyond the imagingcommunity affect sales of imagingequipment.

It is not news to anyone that weare going through some verydifficult economic times.Radiology groups are feeling theeconomic squeeze just like othersmall businesses.

Like many parts of the Obama administration'sstimulus plan, the $19 billion setaside for healthcare IT contains manyuncertainties.

Cardiac imagers are accentuating positive aspects of an international multicenter study of cardiac multislice CT imaging, despite a wide variation in the amount of radiation exposure among 1965 patients and the generally infrequent use of available dose reduction strategies.

Members of the Congressional Black Caucus have joined the ranks of CT colonography advocates to pressure the Centers for Medicare and Medicaid Services to reverse a proposal to deny reimbursement for CTC screening. Proponents argue that the policy could widen existing colon cancer screening inequalities.

Overpayments, particularly for expensive imaging services, are the main culprit for increasing Medicare costs, according to the head of the influential Medicare Payment Advisory Commission.

Cardinal Health opens PET facility for Cornhuskers SonoSite migrates high-end technology to vets

Rebuttal to a proposal by the Medicare Payment Advisory Commission to change the formula for calculating practice expense relative value units for advanced imaging exams has come from Access to Medical Imaging Coalition, a partnership among various professional and trade political interests.

Multislice CT continues to spawn new applications in lung imaging, such as software techniques that allow depiction of airway morphology abnormalities in the prevalent chronic obstructive pulmonary disease. But radiologists are still not doing enough to cut the radiation dose while using the latest imaging tools, resulting in unnecessary and potentially hazardous excess exposure, according to some experts.

A new formula proposed by the influential Medicare Payment Advisory Commission for calculating practice expense relative value units could cut technical payments for MRI, CT, and PET from the Medicare Physician Fee Schedule by as much as 44%.

NYT reports good, bad, uglyHansen buys stake in cardiac therapy firm

It's rare for us to focus closely on medicaltrends in a particular state. We made anexception with this edition's look atPennsylvania, in part because it's an interestingstory, but also because it representsa cautionary tale for all of radiology.

The $1.1 billion in the economic stimulus plan committed to comparative effectiveness research may be good for weighing the relative merits of medical technologies, but it could slow their adoption and lead to European-style rationing, according to Obama administration critics.

Economic issues stretching well beyond the imaging community are affecting sales of imaging equipment. Vendors are responding by lowering prices and designing new, lower cost products. Siemens began the trend with its 1.5T Essenza, priced below $1 million, more than a year ago and followed up last week with the release of an entry-level and upgradable gamma camera, its Symbia E. Earlier this year, Toshiba gave its Aquilion Premium, a 160-channel CT scanner that can be upgraded in the field to the company’s 320-channel Aquilion One, a soft launch. The company decided to forgo the usual attempts to generate publicity and prime the market in order to get the product in front of customers as soon as possible. Philips and GE have each introduced similarly low-cost, high-performance units designed for budget-strapped facilities.

A decision by the Centers for Medicare and Medicaid Services to deny reimbursement for CT colonography screening has shocked radiologists. News that CMS had deemed evidence inadequate to grant coverage left imagers not only dismayed but in disbelief.

The Centers for Medicare and Medicaid Services has proposed that payment for CT colonography be declined, saying there is not enough evidence to support it as a colorectal cancer screening tool.

At a Senate Finance Committee hearing Tuesday, Republican senators questioned whether hefty expenditures for healthcare informatics in the Obama administration’s $825 billion stimulus package will actually help jumpstart the economy.

The American College of Radiology plans to fight proposals in the Congressional Budget Office’s latest report on possible cost-cutting policies affecting medical imaging. College policy experts fear the report may represent the starting point for future payment cuts.

Researchers at a private diagnostic imaging center in central Florida have shown 3T MRI of the wrist is nearly as sensitive and specific as arthroscopy for detection of wrist ligament tears. MR could spot abnormalities missed by standard imaging tests and avoid needless surgeries, according to the investigators.

The Centers for Medicare and Medicaid Services proposed Tuesday to grant routine Medicare payment for numerous cancer-related FDG-PET applications evaluated by the National Oncology PET Registry, a program managed by the American College of Radiology Imaging Network.

The creators of CT screening colonographyhave not waited for the medicalestablishment and insurers to accept itas an alternative to optical colonoscopy.

Radiation dose reduction was a dominanttheme at the 2008 RSNA scientificassembly.

During 18 years as a radiologic technologist, JeffCrowley acknowledged he sometimes thought,"Oh, I can do that," while assisting withprocedures.

Not long ago, our approach to treating difficultmetastatic tumors was to "spray and pray." Weknew that chemotherapy and other traditionaltreatment approaches could cause great damageand had a limited chance of successfully destroyingthe entire tumor.

Medicare’s outpatient imaging program has issued a New Year’s greeting in the form of rules in the 2009 Physician Fee Schedule that raise professional reimbursement rates, expand the discount for contiguous body part imaging to more applications, and introduce anti-markup rules that are far less harsh than those originally proposed.