Expert: Private practices must ‘start small’ before thinking big when developing clinical informatics

Informatics challenges are commonplace for large academic institutions as well as private radiology practices, but the specific hurdles each faces can be unique.

For one, private practices are revenue-driven, so if an informatics project can’t save money or generate revenue it’s less likely that institution will make data-sharing platforms a priority.

Take Adam H. Kaye, MD, with Advanced Radiology Consultants in Bridgeport, Connecticut. After leaving Penn Medicine to become a private practice diagnostic radiologist, he found his institution had been an early adopter of PACS, but prioritized profitable activities with little interest in clinical informatics projects.

And it showed through a reluctance toward costly, but effective MRI prostate screening, little coordination with primary care doctors for lung cancer biopsy follow-up and poor communication with outside entities as a whole.

So where are these opportunities to build up informatics departments for private practices?

“They are mainly from areas of where we can profit,” Kaye said during a presentation at SIIM’s 2018 annual meeting. “You have to create a business plan for some of these projects. That means either through cost reduction, revenue-generation or indirectly through marketing opportunities.”

In one situation, a new interventional radiologist joined Kaye’s team and brought with him an inspiring energy to grow business—specifically in ablations. He suggested radiologists call when encountering a renal mass, so the IR doctor could follow up with the referring physician to build business.

“All the sudden a light bulb goes off in my head,” Kaye said. He had worked on an informatics project at Penn which he then applied at the Cambridge practice. A tweak to their radiology reporting could automatically flag renal masses for ablation and compile that data into a report which was handed to the new team member at the end of each week.

Kaye argued for a reframing of how informatics projects are marketed, along with allies from the physician and IT side as potential solutions for demonstrating the value a strong informatics program can add to practices.

He suggested starting small by joining a standards committee, reaching out to residents and attending teaching conferences—then thinking bigger.

“From there you can think big about getting developer support, database support and integrating with large hospital systems to create a real clinical informatics department," Kaye said.