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LIVE FROM RSNA: Delivering Value for Payment: Are Radiologists and Imaging informatics Leaders Moving Forward?

December 2, 2013
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Change is in the air at RSNA, and the word “value” seems to be on everyone’s lips these days

Change is in the air at RSNA, and one of the clear signs is this: more and more this year than ever before, the conversations I’ve been having with leaders from patient care organizations and from vendor companies have focused around the word value. Yes, value. It’s been a long time in coming, as radiologists have been until recently among the most protected of specialists. But the times, they are a-changin’, as the song goes, as so is the practice of radiology.

As Stephen M. Bravo, M.D., medical director at the Orlando-based Sand Lake Imaging, told me Monday morning at RSNA 2013, being held at the vast McCormick Place Convention Center this week in Chicago, he and his fellow colleagues at his radiologist group were invoking the ire of referring physicians, as they were attracting more business from them, but increasingly falling down on their ability to turn reports around to those referring physicians, because of “traffic jams” in getting their rad tech staff to be able to quickly organize the images from radiologic studies quickly enough. Delays of one or even two days are significant these days, and those were turning off the referring physicians.

Thus, Dr. Bravo and his colleagues turned to the newly upgraded syngo.via platform from the Malvern, Pa.-based Siemens Healthcare, and things have been going far better since then. What’s interesting about this is how the discussion at the Siemens booth immediately turned to value for payment when it came to radiologists and the emerging new healthcare.

The same theme emerged shortly afterwards in my annual RSNA conversation with Henri “Rik” Primo, national director for strategic relationships in the syngo (imaging informatics) area at Siemens, and a true thought-leader in the industry. Rik noted that things are moving forward quickly, with the need for zero-footprint universal image viewing, semantic interoperability for imaging-related communications between and among physicians, and data mining in the service of determining value gaps in radiological service delivery, along with strong health information exchange and vendor-neutral archive-driven capabilities to fuel all those other elements.  Radiologists, he added, will more and more be under pressure to prove their value by going back to a mode in which they actively consult once again with referring physicians, including specialists like surgeons, and leave the darkness of the “reading room cave” in which they’ve lodged for years now.

Similar sentiments came from Ron Cornett, IT director at a 10-location, 40-radiologist practice in Tucson, Arizona, called Radiology, Ltd. Asked his biggest challenges and opportunities right now, Cornett told me, “One of them is the ability to put reports directly into our referring physicians’ EMRs. We’ve been working on that for the past eight years; and we’ve had some forays with HL7 connections, but inevitably, we had ended up having clerically push studies from our PACS system into referring physicians’ EMRs. And that set of tasks has involved a lot of people.”

As a result, Cornett leapt at the chance to be a beta site for the newly activated iConnect Network of the Chicago-based Merge Healthcare, which is

connecting Radiology, Ltd. Directly with clinicians at Marana Health center, a 30-physician local medical group, via cloud-based technology. Cornett is clear on the advantages of deploying this new technology: “The benefits for me,” he told me, “are being able to deliver reports to our referring community where they already work, and being able to launch and view images, seamlessly, where a report is going. If we can deliver our product to referring physicians where they already work, that’s going to help retain them, and will help us. And this kind of exchange also satisfies the meaningful use 10-percent rule.”

That certainly beats having sour conversations with radiologists about how they’re working longer hours in order to keep up their reimbursement!

In any case, I’ve just mentioned the advances taking place at two vendor organizations here; it will be fascinating to hear about others this week. What’s important, of course, is that radiologists, radiology leaders, imaging informatics leaders, and IT vendors are beginning to move now to add value into healthcare delivery, management, and operational processes. Have there been value-driven conversations at RSNA in previous years? Certainly. But it feels now as though radiologists, imaging informatics leaders, and vendors are moving forward in a key area that will become more and more important every day, going forward into an increasingly healthcare reform- and reimbursement-dominated practice environment.