At RSNA 2015 and beyond, radiology is looking at how to transition to value-based care.
As the industry prepares for RSNA15, everyone is looking ahead to what the next 100 years holds for imaging, specifically our commitment to the transition to value-based care (VBC). This evolution is very much alive today, and many imaging professionals and health care leaders are at an interesting point in the journey, which is a topic that will certainly be a central focus at the show. The road ahead for imaging is paved with major operational changes that are necessary in order to meet higher demands for quality. With imaging accounting for an estimated 25 percent of Medicare beneficiary costs, most providers are carefully considering how they can optimize their core diagnostic imaging processes. While the knee jerk reaction is to decrease the number of imaging procedures that are being performed, it is important that health care leaders take a broader, enterprise approach and evaluate the role that imaging currently plays in achieving better outcomes while reducing costs. Evaluating baseline performance using the following guidelines is a good place to start:
• Quality: Is the diagnostic output of the team where it should be? Are the right people doing the right things?
Leaders should consider utilizing strategies that include things such as peer reviews, cross departmental workflow, and sub-specialization workflows, for example. As the chair of the RSNA Scientific Program Health Services Policy and Research subcommittee recently noted, “Quality will be a hot topic at RSNA this year, reflecting the changing landscape and shift towards VBC.”
• Appropriateness: Are the right studies being conducted in order to ensure the best medical impact?[[{"type":"media","view_mode":"media_crop","fid":"43442","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_1806873592300","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4732","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 294px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Tomer Levy, senior member of McKesson’s Imaging & Workflow executive team and General Manager, Workflow and Infrastructure","typeof":"foaf:Image"}}]]
This has three critical parts: 1) making sure that every study is conducted for a specific reason, 2) ensuring that exams have a real impact on outcomes, and 3) establishing strong collaboration across the continuum of care, which will facilitate effective communications among imaging specialists, ordering, and referring physicians.
• Cost and risk: Are the ongoing costs of imaging operations and the process by which to manage those costs well understood? Have ways to continuously improve costs and reduce risk without impacting outcomes been identified?
A proper cost and risk analysis should include data management, workflow, and imaging resource optimization and security measurements. Making images easily accessible from a variety of settings is also important so that imaging teams are providing information to physicians that enables them to make safe and timely diagnoses.
Taking the time to understand where an organization currently stands is an important first step before making any of the changes that are necessary to succeed in the new VBC paradigm. It is only after benchmarks have been set that hospital leadership can build on their knowledge and focus on the next step: working to understand how customers perceive the value that is provided and seeking ways by which to improve.
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