8 keys for radiology to embrace the value-based era

It’s a great time to be a radiologist. Imaging technology is advancing, jobs are plentiful and wages are healthy, wrote a pair of radiologists in a Sept. 4 Radiology commentary.

At the same time, the complexity of the profession and cost of delivering services is rapidly increasing. To continue to thrive, Jonathan B. Kruskal and David B. Larson believe radiology must embrace the concept of value by pursuing two key goals: understand the complex needs of patients and better meet those needs. 

“These two elements are the foundation of the concept of value,” the pair added. “It means that we must continue to learn and improve our performance as individuals, as teams, and as teams of teams, forging learning relationships with members of other teams.”

Kruskal, from Beth Israel Deaconess Medical Center in Boston and Larson, from Stanford University School of Medicine in Stanford, California, cited a number of barriers and solutions to achieve this goal. Below are a few, summarized from the commentary.

Barriers to embracing value

Independence: Many of radiology’s processes and much of its culture are designed around independent radiologists overseeing image acquisition and generating reports. As value continues to be judged organizationally rather than individually, the profession must become interconnected with the health system.

Making accommodations: “Moving to a value paradigm requires that we work around the needs and desires of patients and referring clinicians, rather than expecting them to work around ours,” Kruskal et al. wrote.

Measuring performance: Required measures that place more burden on healthcare and radiology have instilled a skewed perception of value. And there is little benchmarking of outcome metrics that reflect the value of diagnostic radiology services, according to the authors. This must change.

Managing workloads: Radiologists already have a large workload and incorporating value-based strategies may increase that. However, eliminating low-value tasks and the promise of artificial intelligence could help ease that burden.

Transitioning to a value-based practice

Understanding customers: “Radiology practices focused on value understand who are their major referring clinician groups and continuously inquire as to what aspects of performance they most desire to see improved,” Kruskal and Larson wrote. “They then work to meet those desires in a measurable way. The concept of value boils down to this simple principle.”

Communication: Diagnostic radiologists should focus on providing “clear, concise, precise and actionable” reports, the authors wrote. Avoid imprecise terms such as "interval," "short-term" and "non-urgent."

Teamwork: Radiologists must become part of the entire care delivery system, and work as a member of the provider team to cater to the unique and complex needs of patients.

Continual improvement: Becoming a learning organization requires tools for collaborating and sharing radiology knowledge with colleagues. Additionally, practices should strive to embrace peer coaching prospective learning.

Kruskal and Larson admitted radiology as a profession is not going away, but the practices that can’t meet the value-based challenges will be absorbed by those that can.

“For those who are willing and able to accept these challenges as opportunities, this is an exciting time to be a radiologist,” the authors concluded.