Top Trends in Health Imaging: The Rise of Patient-centric Radiology
For imaging stakeholders, fall is the ideal time to reflect on the past year and prepare for the year ahead. Every year, Health Imaging aims to streamline and inform the process with our Top Trends in Health Imaging survey.

We solicit input from an array of decision-makers to learn more about their business concerns and challenges, budgets in imaging and informatics and operational plans for the short term.

From the data, key trends have emerged. Reimbursement cuts continue to hurt radiology, setting imaging departments and practices on an ongoing quest for improved efficiency. We also see the patient moving toward center stage. Practices that recognize and actively respond to this trend as well as those that leverage informatics investments in data mining and strategic planning could gain a competitive advantage.

Business concerns from last year to this year are holding fairly steady, with customer satisfaction nabbing the top spot this year. So that puts referring physicians and patients in the spotlight. (In 2010, decreasing reimbursement topped the list.) Other pain points that didn’t quite make the top five include radiation dose, regulation and keeping pace with new technology.

Top five business concerns
1. Improving customer satisfaction
2. Decreases in reimbursement
3. Improving workflow and productivity
4. Creating new revenue sources
5. Competition from other organizations

Feeling the pinch: Revenues take a hit

The combination of the ongoing economic malaise and reimbursement cuts is impacting imaging revenues. The number of organizations with declining revenues crept past those increasing revenues, with 27 percent of respondents reporting revenue increases and 29  percent reporting decreases in 2011. Forty-four percent held steady.  The top reasons for revenue increases offer a strategic roadmap and goals for imaging enterprises. These organizations demonstrate that it is possible to perform efficiently, meet customer needs and profit despite the tough climate.

Top five drivers for increased revenue
1. Implemented operational efficiencies
2. Reduced costs
3. Increased marketing in service area
4. Improved customer service/patient satisfaction
5. Added new clinical service line(s)

On the flip side, nearly half of the organizations with declining revenues realized drops of just 5 to 10 percent.

Respondents attributed the revenue slides to five factors:
1. Cuts in Medicare reimbursement
2. Reduced reimbursement by insurance companies
3. Increase in uncompensated care
4. Higher level of bad debt write-offs
5. Decreased number of outpatient visits

With 2012 (and ongoing challenges) looming, many organizations are planning to leverage tried-and-true methods to build their physician referral base and increase revenue. More than 90 percent of respondents are working to increase their referral base. Increasing efficiency while simultaneously improving access to images and data are preferred strategies.

The primary mechanisms for achieving the goal are remote access to images and reduced image and report turn-around time. Other popular tools include a marketing representative, remote access to the EMR and partnerships with physician groups.

Nearly half of respondents say their organizations plan to add new clinical service lines to increase revenue. Women’s health was the most popular area. Other choices are cardiology, outpatient centers and oncology.

Imaging systems budgets: Holding steady

Respondents who report an increase in their imaging systems budget are focusing on infrastructure investments—updating facilities and upgrading IT infrastructure. Meanwhile, the most oft-cited reason for a decrease in the imaging systems budget is an overall business decrease, with declining business taking second place.

DR and CT are  second and third on the list of modality purchases planned for 2012 (See chart, bottom left). While organizations have honed in on 64-slice CT as the sweet spot, the DR market is a bit murkier as sites consider retrofits.  The CT Sweet Spot: 64 slice
1. 64-slice
2. 128-slice
3. 16-slice
4. 256-slice
5. 320-slice

Clinical information systems budgets: Strong and steady

Clinical information systems budgets are holding steady in 2011. More than half of respondents expect no change, and another 35 percent expect an increase in spending. The most common reason for an increase? Improving quality.

Once again, the basics topped the list of planned investments. Radiology PACS and RIS, the latter of which  is the powerhouse of meaningful use for radiology, nabbed the top two spots for replacements or upgrades in 2012. The pathology PACS market seems to be expanding with multiple organizations rating it fairly high on the wish list.

IT budgets creep Up

IT budgets are on the uptick, largely because informatics is absolutely essential to the drivers of success in the business of imaging: efficient operations, healthcare reform and federal regulation.

The majority of respondents expect increases in their IT budgets in 2012, with hefty increases of more than 50 percent expected at nearly 10 percent of organizations.

Basic infrastructure remains a pressing need for many organizations. Nearly half say they expect to add workstations, desktops or mobile computers in 2012. Wireless technology (think anywhere, anytime connectivity and souped-up efficiency) also ranked high. Finally, technologies that support the end goals of meaningful use, healthcare reform and operational efficiency also appear high on the wish list. Nearly one-third of respondents expect to replace or upgrade an EMR, followed closely by investing in business intelligence/metric tools and computerized physician order entry.

Survey at a Glance

The 2011 Top Trends in Health Imaging survey exceeded our expectations. Nearly 400 imaging decision-makers responded, representing the hospital C-suite, imaging center and physician practices, directors of radiology, radiology administrators, radiology chiefs and more. The influx of responses bested 2010 by nearly 100.

We surveyed Health Imaging enewsletter subscribers and partnered with AHRA to garner input from their members. Responses were collected from July 26 to Aug. 31 and analyzed in September.