WASHINGTON, DC-Suggestions for how radiology practices can increase value from an operational perspective were discussed at ACR 2015.
The elegant simplicity of the general value definition, outcomes relative to costs, masks extraordinary underlying complexity, Richard Abramson, MD, of Vanderbilt-Ingram Cancer Center, said at ACR 2015.
Abramson noted that the definition of value is especially problematic for radiology because it looks at maximizing long-term, down the stream outcomes. Radiology, however, is one link in a long causal chain and radiology’s contribution to long-term outcomes is harder to identify in this extensive chain.
The point is, however, Abramson said, that just because something is hard to measure doesn’t mean it’s not worth measuring, or attempting to measure.
“If ultimately we decide we can’t measure value accurately to the emth decimal place, it probably still makes sense [to think about value] for strategic planning,” he said.
Perspective is also an important component in defining value because value varies depending on the stakeholder.
Abramson argued that existing value models claim that the radiologist’s value comes from interpretive work, but examining the noninterpretive activities, and considering them separately, provides potential opportunities for radiology to increase value.
Abramson outlined several initiatives that practices around the country are focusing on as operational strategies to increase value. A few are listed below:
Exam selection/scheduling: Practices can reach out and partner with referring physicians to create diagnostic algorithms around different patients. Scheduling portals are seeing more traction to simplify the scheduling process for referrers and patients, he said.
Decision support: Decision support isn’t just technology, Abramson said. “The core of decision support is good old-fashioned radiologist consultation, and there is a lot practices can do to enhance their consultative role that doesn’t involve implementing expensive IT solutions.”
Abramson gave the examples of a dedicated radiologist hotline for consultations about appropriateness, or a “doc of the day” pager. He noted that some of the old-fashioned solutions are resurfacing as practices try to demonstrate they are willing to go above and beyond with consultations.
Technical operations: It’s the norm for practices to have scanning protocols, but system operations protocols should be developed as well, Abramson said. Issues like contrast administration and patient safety provide opportunities for standardized protocols and will demonstrate to the health system and other stakeholders that a practice is engaged in appropriate and efficient care for patients.
Workflow management, equipment supply: Practices can standardize low-level, smaller purchases of supplies and then work with the larger health system for larger, big-ticket purchases.
Optimize staff and workflow: Optimizing staff coverage optimizes a practice’s efficiency, but there are also workflow solutions a practice can implement, such as triaging stations, or a process to have all prior exams pulled into PACS.
Teleradiology: Abramson noted the teleradiology controversy, but pointed out that teleradiology coverage is especially beneficial in having off-hour coverage, and showing commitment to having subspecialists available.
Marketing: Practices can demonstrate value by participating in hospital marketing efforts, as well as physician and community outreach. He gave a breast cancer awareness program as an example of a community outreach event.
A Victory for Radiology: New CMS Proposal Would Provide Coverage of CT Colonography in 2025
July 12th 2024In newly issued proposals addressing changes to coverage for Medicare services in 2025, the Centers for Medicare and Medicaid Services (CMS) announced its intent to provide coverage of computed tomography colonography (CTC) for Medicare beneficiaries in 2025.
The Reading Room: Artificial Intelligence: What RSNA 2020 Offered, and What 2021 Could Bring
December 5th 2020Nina Kottler, M.D., chief medical officer of AI at Radiology Partners, discusses, during RSNA 2020, what new developments the annual meeting provided about these technologies, sessions to access, and what to expect in the coming year.
ACR Collaborative Model Leads to 35 Percent Improvement with Mammography Positioning Criteria
July 1st 2024Noting significant variation with facilities for achieving passing criteria for mammography positioning, researchers found that structured interventions, ranging from weekly auditing of images taken by technologists to mechanisms for feedback from radiologists to technologists, led to significant improvements in a multicenter study.
New Study Shows Non-Radiologists Interpreting 28 Percent of Imaging for Medicare Patients
June 28th 2024While radiologists interpreted approximately 99 percent of all non-cardiac CT, MRI and nuclear medicine studies in hospital and emergency department settings for Medicare beneficiaries, new research shows significantly less radiologist review of cardiac imaging and office-based imaging.