Facility Management

Radiology groups are producing more work per full-time equivalent than ever before. Yet in many cases, their incomes are flat or decreasing. One of the major factors contributing to this phenomenon is consolidation within the healthcare insurance industry. This consolidation has fueled new rounds of cost-cutting by the major carriers. To remain competitive, other insurers are following suit.

Next week at the SNM meeting, Hitachi Medical Systems America (HMSA) will unveil a new version of its Sceptre PET system, one dedicated to cardiac applications. The system, called SceptreC, is configured to use rubidium-82 to gauge myocardial perfusion and fluorine-18 FDG to assess myocardial viability.

For all their promise, information systems don’t appeal much to my sons’ pediatrician. The system installed in his clinic does not live up to its promise. It doesn’t even come close. Aside from a learning curve that continues to rise, even though it’s been in place for six months, the system that is designed to make his life easier does not. Most maddening is how it restricts him from keying in the dosage he wants to prescribe. This might be understandable, if that dosage veered from the norm. But it doesn’t. So important is the dosage on this particular drug that the manufacturer has actually packaged the drug in specific quantities in plastic, foil, and cardboard. This does not matter, however, to the information system, which robs our doctor not only of his time but ours.

Rather than fight to repeal the Deficit Reduction Act of 2005, the American College of Radiology has chosen instead to support a two-year delay in its implementation.

Executives at Kitchener, ON-based Medicalis want to help referring physicians and radiologists make the right decisions. The company has come up with Web-based software that helps physicians at the point of care choose the right imaging exam based on its clinical appropriateness and the likelihood of receiving reimbursement for it.

For all their promise, information systems don’t appeal much to my sons’ pediatrician. The system installed in his clinic does not live up to its promise. It doesn’t even come close. Aside from a learning curve that continues to rise, even though it’s been in place for six months, the system that is designed to make his life easier does not. Most maddening is how it restricts him from keying in the dosage he wants to prescribe. This might be understandable, if that dosage veered from the norm. But it doesn’t. So important is the dosage on this particular drug that the manufacturer has actually packaged the drug in specific quantities in plastic, foil, and cardboard. This does not matter, however, to the information system, which robs our doctor not only of his time but ours.

Understanding the rules and regulations as they apply to purchased diagnostic testing and professional courtesies is necessary if vendors are to appreciate the pressures that providers -- especially those in outpatient settings -- must face. In my experience as a consultant, I see vendors book orders that get canceled months later because their customer lacks the proper legal structure to qualify for Medicare’s safe harbor rules.

Hundreds of facilities that preregistered for the National Oncologic PET Registry might be caught off guard by recently enacted changes, according to Dr. Barry Siegel, cochair of the NOPR working group.

After more than a year of delays, the National Oncologic PET Registry will officially launch on Monday, May 8. It is intended to gather data proving the efficacy of FDG-PET imaging to diagnose, stage, and manage rare cancers currently not covered by Medicare.

Minimally invasive CT colonography has been embraced by radiologists and patients alike. As the technique evolves, its use is shifting from specialized academic centers to community hospitals and private practices. That transition is focusing increased attention on reimbursement, clinical efficacy, and interpretation issues. Computer-aided detection for CTC could affect all three.

"Bones! You've got to do something."

A powerful clinical case can be made for using cardiac CT angiography as a screening tool to help avoid cardiac catheterization. But does the technique make financial sense in nonemergent cases? A new cost-effectiveness study says yes -- if the price is right.

Tumors require new blood vessels in order to grow beyond a few millimeters in size. Once this "angiogenic switch" is thrown, a series of events occur that lead to the progression and spread of cancer. The vessels formed by tumors are not only larger and more numerous but also more permeable than normal vessels1 (Figure 1). Thus, when a patient with a tumor is injected with a gadolinium-chelate MR contrast agent, the tumor enhances more than the surrounding normal tissue.

Of the $120 billion spent on healthcare in the U.S. annually, about 10% to 20% is wasted on inappropriate treatment. What if some of those funds were invested in enterprise information systems? Imagine the possibility of routinely using such systems to identify trends in medical imaging procedures and highlight potential errors, inaccuracies, and waste.

Working smarter is a critical element of improving workflow. At the Society for Computer Applications in Radiology meeting today, Cerner unveiled a work-in-progress that addresses that point head on.

Carrie Becks, president of RED Marketing and Jerry Dalrymple, MD, owner and medical director of Parkview Imaging, outline the essentials for communicating with patients and referrers.

Revenue from the delivery of new CT units in the U.S. last year grew 15% compared with the previous year, and unit volume rose about 3%, making 2005 the best sales year in the history of the modality. The availability of 64-slice scanners capable of coronary CT angiography led the industry to those heights. This year, however, vendors are just hoping to hold onto last year’s gains.

Radiofrequency ablation is a growing part of the practice established by interventional radiologist Dr. Paul Christy and his partners at Methodist Hospitals’ Interventional Radiology Center in Omaha. Most of their RFA practice focuses on lung tumors, but they also treat tumors of the liver and bone. The 13-person group includes one part-time and two full-time interventional radiologists, as well as medical oncologists, radiation oncologists, surgeons, and other specialists.

Larry Dentice wants to take Toshiba America Medical Systems to the next level. TAMS is coming off a stellar year during which sales rose 25%, but to continue that growth the company must make some refinements, according to its new general manager.

Teleradiology has apparently come of age. Imaging examinations can be sent via high-speed connections to anywhere in the world, at increasingly low cost. Teleradiology also appears to be a profitable business. Take, for example, the services emerging to cover the night shift for U.S. radiologists. Teleradiology Solutions and TeleDiagnosys Services are just two of the many enterprises in the field, both offering this service from a base in India.

Efficiency is driving the IT market, and brokerless information exchange is driving efficiency at institutions deploying IT products from Misys Healthcare Systems.

Diagnostic radiologists are the most important physicians patients will never meet. They are the M.D. equivalent of pharmacists, taking orders from attending physicians and filling orders, hovering in the shadows of medical care, and observing what’s going on but not participating.

Demand dropped for gamma cameras in 2005, while it boomed for PET/CT. Trends driving this teeter-totter market, which links these two related but very different modalities, are continuing but moderating, according to industry sources.

Congressional moves to cut Medicare payments for outpatient imaging procedures tops the list of what worries executives at Toshiba America Medical Systems. But reimbursement problems won’t stop the company from developing and promoting new imaging technologies.

Yale University researchers have introduced an endovascular technique that takes up a notch the embolization of the varicose veins that cause varicoceles and chronic pelvic pain.

A new CPT code set to take effect July 1 might serve as an added incentive for the purchase of computer-aided detection systems for breast MR. But Confirma, the leader in MR CAD, isn’t counting on it to boost sales.

Diagnostic radiologists are the most important physicians patients will never meet. They are the M.D. equivalent of pharmacists, taking orders from attending physicians and filling orders, hovering in the shadows of medical care, and observing what’s going on but not participating.

Optical imaging may soon enter the medical mainstream with a handheld device that developers say will help providers of emergency care quickly diagnose brain hematomas.

An electronic form of brachytherapy could propel radiotherapy beyond oncology clinics and into radiology departments and possibly even imaging centers.

Patients often ask sonographer Cynthia Rapp just what it takes to perform ultrasound. Her frank response about the necessary qualifications sometimes comes as a surprise.