2012 September/October

September may be my favorite month of the year. The hot, muggy days of August have ceased, replaced by fresh fall air with just the right nip of cool on most days. Backpacks are full, dorm rooms are decorated and school buses prowl the streets as parents and kids anticipate a new school year and fresh start.

Accountable care organizations (ACOs) have befuddled imagers, with radiologists wondering how the specialty might fit into a model seemingly focused on primary care. ACOs have been a hot topic for several years, and generate many unanswered questions. How will the model differ from health maintenance organizations? What methods will they use to cut spending? The answers remain elusive, but with more than 200 ACOs in various stages of operation in the U.S., its time for radiologists to take charge of defining imagings role in the ACO model.

Growing up is a tough business. Safety is constantly on the radar; questions seem incessant; solutions can be elusive; and consistency appears improbable. But after 18 or so years, the end result more than justifies the inputs. The similarities between shepherding a toddler to teen years and beyond and managing an imaging modality from near universal utility to safe, targeted use are striking.

Radiologists and other imaging professionals in the U.S. are getting involved in efforts to improve healthcare quality using health information systemsby increasing the amount and quality of information, including patients histories and imaging exams, available to members of the care team at the point of care. Health information exchange (HIE) may be crucial to meeting this goal.

In radiology, acquiring the image is only part of the job. Effective communication of image data is key, particularly in urgent cases. Communication of critical radiology results has wide-reaching implications, from patient safety to regulatory compliance.

Cardiac PET has always taken a backseat to SPECT imaging in terms of volume. But, whether it is the quality of PET images or recent technetium-99m isotope shortages, more providers are giving PET a second look. Before committing, they need to consider the financial and practical challenges of introducing a cardiac PET program.

August marked the one-year anniversary of the first procedures performed in the Advanced Multimodality Image Guided Operating Suite (AMIGO) at Brigham and Womens Hospital in Boston.