Practice Management at RSNA: Survival of the Fittest

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Lisa Fratt, Editor

The rate of change and level of uncertainty in the radiology business may have reached all-time highs in 2010. Although its rules and ramifications may be a bit murky and newly empowered Republicans are vowing to repeal the Patient Protection and Affordable Care Act, healthcare reform is likely to be here to stay in one form or other. Early indications are that HITECH (Health IT for Economic and Clinical Health) Act funding is secure for now.

Specific elements of the legislation—quality, safety and health IT adoption—are keepers. The good news is that radiology is ahead of the game in terms of health IT adoption. However, imaging was barely given a second glance as the feds crafted Stage 1 meaningful use requirements, feeding uncertainty and skepticism in the imaging community. Yet, the law does impact radiology in other critical ways.

Healthcare reform is certain to exacerbate the challenge of the aging population and increase the number of patients and demand for healthcare, including imaging. Now, the issue extends beyond more patients and extends to new quality and safety requirements. Radiology, like providers across the enterprise, needs to adjust to the evolving practice model.

(Read more about the informatics and economics implications of meaningful use at Health Imaging & IT’s RSNA informatics preview.)

Surviving and thriving in the new environment requires razor-sharp focus on both patient care and efficiency. Earlier this year, respondents to Health Imaging & IT’s annual Top Trends survey identified patient satisfaction as a top business concern. Smart providers are differentiating themselves with outstanding patient service ranging from minimal wait times to improved scheduling and faster report turnaround time. RSNA 2010, in partnership with the American College of Radiology (ACR), also is tackling the topic of the patient-centered radiology practice during the Patient-centered Radiology: It’s Good Business session on Sunday, Nov. 28.

Delivering meaningful practice improvement requires data and metrics. Whether the term is digital dashboard, key performance indicators or business intelligence, an IT platform for observation and measurement is essential.

Again, radiology may have a leg up over clinical colleagues because it completes many processes and transactions in an automated fashion. “Mining imaging databases creates an opportunity for quality improvement,” explained Ramin Khorasani, MD, vice chairman department of radiology at Brigham & Women’s Hospital in Boston. “[I]f we could identify those databases and harvest data from them, we could create a virtual dashboard of our practice to get us started in a meaningful way.”

A well-defined, IT-based process allows practices to gather baseline data, formulate a plan with goals to address their specific needs and measure results.

Dashboard super-user Massachusetts General Hospital in Boston tracks more than 100 different metrics and has leveraged data to pull off multiple practice improvements including a dramatic reduction in report turn-around time. While report turn-around, results communication and efficiency are hot topics and critical differentiators in an increasingly tight market, other issues are equally important.

Take imaging utilization. Study after study question imaging overuse, inappropriate use and high costs, which are approaching nearly $100 billion annually in the U.S. and growing at a 17 percent clip. And the furor over radiation dose fans the fire. It’s no surprise that the conversation has turned to curbing self-referrals and promoting appropriate use.

Yet, IT offers solutions. For example, in the December issue of Health Imaging & IT experts predict that next-generation efforts to trim imaging utilization will take the form of decision support and not radiology benefits management companies. RSNA also is highlighting both appropriate use and decision support in its educational offerings.

The RSNA 2010 practice management slate reflects these various challenges (and much more) and is certain to provide visitors with ample tools to drive practice improvement.

Lisa Fratt
Editor of Health Imaging & IT