Facility Management

Convincing evidence suggests that, as suspected, managed care companies lack the ability to properly adjudicate claims and pay the contracted amount for services rendered.

While clinical data supporting the effectiveness of tumor ablation is growing, educational opportunities for physicians who want to learn new techniques or get tips on developing a tumor ablation practice lag behind. Some training is available through CME courses, industry society events, vendor education, and informal arrangements with luminaries, but large-scale, organized training regimens do not yet exist.

No better way exists than functional MRI to plot the intricate neural pathways of the brain. Neurosurgeons regularly call on this technique to plan surgical routes around eloquent brain areas, yet fMRI’s potential has remained untapped, largely due to benign neglect on the part of developers and third-party payers. The recent formation of a society dedicated to fMRI might change that situation.

Any reputation for excellence that Roxborough Memorial Hospital in Philadelphia might have tends to be eclipsed by its larger academic neighbors. Dr. Robert Worthington-Kirsch, however, wouldn't trade the small-town flavor of Roxborough Memorial for the publish-or-perish world of academic centers. It helps that he doesn't need to, as he is one of a handful of successful solo interventional radiology practitioners in the nation.

Convincing evidence suggests that, as suspected, managed care companies lack the ability to properly adjudicate claims and pay the contracted amount for services rendered. As a result, every radiology practice must routinely verify managed care payment compliance by tracking and reporting third-party payment practices.

Although musculoskeletal radiologists have long debated the relative roles of MRI and ultrasound in imaging shoulder injuries, they have reached consensus on a number of diagnostic algorithms. But the proliferation of inexpensive, low-end compact ultrasound systems has introduced a new controversy.

Hot on the heels of a successful 3D workstation face-off at last year's meeting, the Society for Computed Body Tomography and Magnetic Resonance this year has invited PACS vendors to submit their systems for what will be the first ever PACS showdown.

The adoption of new imaging technologies presents multiple challenges to hospitals, radiologists, cardiologists, payers, and vendors. Sixty-four-slice CT, which has enabled the clinical evolution and market adoption of coronary CT angiography, is not a disruptive technology. But CCTA is, as evidenced by questions raised about its clinical impact and the push for new credentialing standards by organizations.

The American College of Radiology and the American College of Cardiology called a truce in their turf battle over cardiac CT to jointly write a document intended to help local Medicare insurers set the terms for the acceptance and coverage of cardiac CT procedures.

Before considering revascularization procedures, surgeons want proof of ischemia. While catheter angiography has value in assessing lesions associated with coronary artery disease, it cannot assess the associated ischemia. PET imaging is increasingly being used to provide that information. With the rise of multislice CT angiography as a first-line test for patients with suspected CAD, researchers have set their sights on integrated PET/CT for combined acquisition of coronary anatomy and perfusion.

After a year of hammering out the fine print, the Centers for Medicare and Medicaid Services and the Academy of Molecular Imaging announced this month that they have started collecting data for the National Oncologic PET Registry.

Traditional forms of radiation therapy have a formidable new competitor. A nonradioactive form of brachytherapy, cleared late last year by the FDA and being readied for preliminary roll out, dramatically reduces the length of treatment for early-stage beast cancer following lumpectomy and promises to bring radiation therapy to physician offices and imaging centers.

After twice considering and rejecting endorsement of CT colonography as a cancer screening tool, the American Cancer Society is taking another look. Prompted by advances in reporting standards, technique, and training, the ACS may include the virtual colonoscopy technique as an optional test in its colon cancer screening guidelines by year's end. Such a move, coupled by favorable results from a national clinical trial, could push CTC into the practice mainstream, bolstering adoption, furthering development of computer-aided detection, and most important, fostering reimbursement.

Acquiring information about mammography procedures is one thing. Using that information in a report and follow-up is something else. That's where programs like MagView come in. The mammography information system can be configured with integrated scheduling, billing, radiology reporting, transcription, patient tracking, management reporting, and equipment quality control.

Sweaty hands, or palmar hyperhidrosis, can hinder a person’s social or professional life. A minimally invasive procedure performed under CT fluoroscopy guidance provides a permanent solution to the embarrassing problem, according to Belgian researchers.

The U.S. House of Representatives narrowly passed a $39 billion budget-cutting bill yesterday with provisions that significantly reduce Medicare reimbursement for imaging services.

Day-to-day radiology practice has changed immeasurably over the past 20 years. Many senior radiologists will no doubt recall how, as residents, they were asked to review 50 to 100 conventional x-rays each working day. Today, a single trauma patient can generate 1500 to 2000 images. As a result, if a dozen or so emergency cases arrive during the night shift, the resident on duty could be overwhelmed by more than 25,000 images to review.

MR-guided laser ablation proved as effective as the current standard of care for the treatment of liver tumors in a study by University of Frankfurt researchers. The trial highlights the largest patient population and longest follow-up of its kind.

New technology now allows bone densitometers to make a more visible contribution to evaluating risk of osteoporosis. Scans that once generated only quantitative measurements can be postprocessed into low-resolution images of the spine. This capability is designed to help physicians spot deformities in vertebral bodies that might otherwise go unnoticed.

Newly developed ultrasound probe technology that acquires data in one sweeping stroke is propelling 3D ultrasound into new realms. Aided by software that reconstructs volumetric information, radiologists can review ultrasound data on workstations the same way they do CT and MR.

Two different advanced MRI techniques can help clinicians choose epilepsy patients who will favorably respond to surgical intervention, according to a pair of studies published in the October 2005 issue of Neurology.

With the growing use of physician privileging, a license to practice medicine no longer functions as a free pass for practitioners to perform whatever diagnostic imaging they choose in their clinical practice. Private insurers are learning that privileging-policies that permit payments only to physicians who possess specific educational credentials-can combat inappropriate utilization and prevent shoddy quality.

The FDA approved use of tissue plasminogen activator (tPA) for stroke in 1996, but it took another 10 years for the Centers for Medicare and Medicaid Services to offer reimbursement. The agency's decision is part of a larger trend that recognizes the value of preventive care and treatment compared with the cost of longer hospital stays.

While Republicans and Democrats each claimed victory Wednesday in the contentious battle to pass a budget resolution, radiologists on both sides are declaring themselves the losers.

For radiology to move into the digital arena in underserved areas around the world, financial, cultural, and technological stumbling blocks have to be removed, according to a recent case study.

A substantial amount of clinical data shows that radiofrequency ablation of small kidney tumors is a safe and effective alternative to open or laparoscopic resection. Distinct intervention protocols and complementary techniques could further boost RFA's efficacy and expand its application to areas where it was previously deemed unsafe.

Increasing workload is a common trend in radiology departments throughout Europe. The question is, How can we measure it effectively?