Facility Management

The radiology department at Leiden University Medical Center performs approximately 150,000 examinations each year. We developed and implemented a simple fee-for-service tool to monitor clinical output and relate this to required input.

The Centers for Medicare and Medicaid Services approved in January a narrow coverage for FDG-PET imaging of cervical cancer. Medicare will reimburse for the initial staging of cervical cancer in a patient with a negative CT or MRI for extrapelvic metastatic disease.

The RSNA projected its 2004 meeting as "radiology's global forum," which was more than a catchy slogan. Congress president Dr. Brian C. Lentle was born in Cardiff and trained at the University of Wales, and four doctors from the Republic of Ireland, France, Australia, and England were made honorary members at the meeting. The scientific program was dedicated to Englishman Sir Godfrey Hounsfield, the inventor of CT, who died last August.

The radiology department at Leiden University Medical Center performs approximately 150,000 examinations each year. We developed and implemented a simple fee-for-service tool to monitor clinical output and relate this to required input.

Digital mammography has so much to offer that it might, almost, overcome the fact that it has yet to prove clinical superiority over screen-film mammography. Many users have, in fact, already decided that digital is worth its higher cost-about 40% of all mammography systems sold in the first half of 2004 were digital.

In a move likely to help teleradiology services and the companies that provide their equipment, the Centers for Medicare and Medicaid Services will soon implement a policy that permanently relaxes billing requirements for offsite readers. The shift, which is expected to take place by April, could create business opportunities for teleradiology and nighttime interpretation companies, as well as for hospitals and radiology groups across the nation.

Cardiologists can make money owning CT scanners and performing coronary CT angiography, according to Timothy Attebery, CEO of South Carolina Heart Center in Columbia. Income from the center's coronary CTA scans has risen from $200,000 in 2002 to a projected annualized income of $1 million in 2005.

The talk at the 2004 RSNA meeting was all about CT. Even with only the smallest handful of papers presented on 64-slice experience, radiologists discussed the latest generation of scanner as the new must-have equipment.

It's not a question of if, but of when. Both academic and private-practice radiologists who perform cardiac CT angiography predict that reimbursement for the procedure will become widespread within a year.

Faced with possible Medicare payment cuts, the American College of Radiology will lobby Congress for legislation that would require Medicare to define physician qualifications for performing diagnostic imaging.

Radiology groups in growing numbers are entering into imaging joint ventures with hospitals. These are beneficial to both parties for many reasons, but all such joint ventures must address important strategic decisions. One is the choice of what Medicare enrollment status the joint venture will operate under. This choice is generally enrollment as an independent diagnostic testing facility (IDTF) versus radiology group practice. The latter is the better choice, in my view, but the requirements for onsite service by the radiologists can make qualifying for non-IDTF status difficult.

About 90 digital mammography systems were shipped to U.S. customers in the first half of 2004, compared with 130 film-based units, according to industry executive estimates. Full-field digital mammography systems thus accounted for almost 40% of the units delivered in the first half of last year. The percentage of revenue tips the scales in FFDM's favor, as each digital system sells for more than a half-million dollars, about six times more than the cost of a film system.

Digital mammography has so much to offer that it might, almost, overcome the fact that it has yet to prove clinical superiority over screen-film mammography. Many users have, in fact, already decided that digital is worth its higher cost-about 40% of all mammography systems sold in the first half of 2004 were digital.

The continuing challenge for every specialty in oncology is to improve the therapeutic ratio, which is the balance of the biological effectiveness of the treatment and the severity of treatment-related side effects.

Several oncologic imaging modalities have evolved significantly since CT was developed in 1973. Although CT provides a noninvasive method for evaluating cancer patients, first-generation scanners were limited in their speed of data acquisition and spatial resolution. Current multislice CT scanners can evaluate a patient completely, with exquisite anatomic detail, in as little as 15 to 30 seconds.

Integrating a profusion of digital healthcare information systems is central to providing efficient, high-quality healthcare, and this need spans national boundaries.

The Centers for Medicare and Medicaid Services has announced a new initiative to provide reimbursement for PET when patients and physicians participate in high-quality clinical studies or submit information to a PET data registry. The announcement heralds a move away from PET coverage decisions on an indication by indication basis.

Paperwork for hospitals and facilities using teleradiology services has gotten easier since the government enacted interim guidelines relaxing billing requirements for out-of-state interpretations. Final regulations should be in place by April.

VitalWorks changes name, completes medical division saleIT developer VitalWorks has completed the sale of its medical division to Cerner for $100 million in cash. The company announced Nov. 15 a definitive agreement to sell the division, following its decision to focus on radiology IT systems. With the deal now finished, the company has changed its name to Amicas and moved its headquarters to the Boston digs of this PACS vendor, which VitalWorks acquired in late 2003.

Faced with possible Medicare payment cuts, the American College of Radiology plans to lobby Congress for legislation that would require Medicare to define physician qualifications for performing diagnostic imaging.

Virtual colonoscopy took a roller coaster ride last year. Some peer-reviewed studies touted the technique, while others favored conventional colonoscopy. Experts on each side complained of flaws in the other side's methodology. With that background, an international working group has developed a standardized reporting system for CT colonography.

The Sequoia Imaging Center of Visalia, CA, was to be a full-service operation, featuring everything digital from MR to DR. But it almost didn't happen, at least not by the scheduled grand opening. As the deadline approached, digital radiography was threatening to make a mess of it. Director of imaging services, Gordon Ah Tye, was fed up.