Trend Tracker | Images & Workflow: Crafting a Roadmap

I'm expecting RSNA 2005 attendees to focus on the basics this year, as they tour the exhibits, attend some educational sessions and talk shop with colleagues in Chicago.

For most radiologists, images are still the key reason for attending the meeting. For all others, there is an even larger offering of products and technologies related to matters of practice management, referring physicians, billing - and oh yes, patients, too.

At the past three RSNA meetings, I've spent considerable time evaluating the progression of IT into the medical imaging space, and plan to do so once again - it's where the action is, and certainly based on recent mergers and acquisitions activity among medical imaging suppliers such as:

  • GE + IDX
  • Philips + Stentor
  • Merge + Cedara
  • Agfa + Heartlab
  • McKesson + Medcon

None of these deals were based on new and improved imaging products, they were driven by IT business opportunities tightly linked to the medical specialties which rely on images - namely radiology, cardiology and orthopedics. There are other deals as well, but the point is the IT + imaging market space is active, growing and in play.

This IT consolidation action is not just about gaining or retaining market share in the PACS market segment - the opportunities for IT solutions have grown much larger and more extensive. Healthcare IT has become the catch-all market for anything related to the storage, recall and exchange of healthcare information in electronic form. Databases, archives and networks are the building blocks, but the applications are the real point of interest for medical care professionals, especially departmental focused solutions. These departmental solutions now incorporate integrated suites of formerly discrete applications, now tailored to the unique workflows of a medical specialty, whether for radiology, cardiology, surgery or oncology - let alone any other caregivers throughout the enterprise who need access to this information. Workflow improvements lead to productivity and service improvements, and thus provide a compelling value for buyers.

Now, back to the show. I have a simple recommendation this year for attendees - start building a 5-year road map for your radiology, cardiology or oncology practice. OK, you may or may not have done this before, but try thinking of this as a 10-minute rough draft that you can then spend the rest of the week refining into a 2-page document. Write down where you expect to be in 5 years, and then fill in the gaps from where you are today. This will help you identify the topics that you should dive into during the meeting.

The road map should include:

  • New or reduced imaging assets: CT, MRI, PET-CT, CR, DR and angiography
  • Applications: Neurology, cardiac and breast cancer
  • Specialties: Sports medicine, ER and interventional radiology
  • Practice management: RIS, HIS, PACS, HIPAA, billing and coding
  • IT efforts: Network management, reports, paperless office, scheduling, orders, content and knowledge management
  • Business Analysis: Finance, operations and data mining

The challenge is to think more globally about your practice and its reach into the business of referring physicians, payors and patients. Patient images are the center of the universe, but it is IT (not gravity) that holds the rest of the universe together. Reports seem like such a trivial item when standing next to a $3 million 3T MRI scanner, but a timely report is, in fact, worth far more to a patient and the referring physician. The report can be especially valuable when the radiologist is able to quickly access the prior imaging study from the online archive (in less than 5 seconds), including the original report, and orders. All of this and more can happen, but it usually does not happen by magic or luck - it all starts with a plan.

So, if RSNA means it is time to break out the cold-weather clothes once more, then make sure to take the time to read, reflect and plan a little on where you'd like to be 5 years from now. And no, it is not allowed to plan on RSNA moving to Orlando - been there, done that. But you are highly encouraged to attend HIMSS (San Diego in February) and SCAR (Austin, Texas in April) as well, and invest the same effort in adopting leading edge IT that you already invest in leading-edge imaging technology.

Happy Thanksgiving!

Douglas F. Orr is principal of J&M Group. Send Trend Tracker questions and comments to