Improved patient outcomes and reduced costs have been the driving forces for change in healthcare during the past three decades. With the standardization around Digital Imaging and Communications in Medicine (DICOM) in the early 1990s, radiology has been at the forefront of healthcare’s pursuit of an interoperable, comprehensive patient view.
It’s now time for the profession to take the lead again with the migration to Enterprise imaging. Enterprise Imaging encompasses the capture, transmission, reading, storing, viewing, and management of all images and imaging data generated by all providers across all the departments of all the organizations in the care continuum. This includes images generated by radiology, cardiology, GI, dermatology, and other imaging specialties as well as visible light images from areas such as wound care, the ED, images acquired by patients for virtual visits and so on.
Fast forward to 2016. While we’ve come a long way since those early days, there’s still work to be done in expanding patient coverage and improving quality. The ultimate goal of interoperability is in reach, but it hinges on enterprise-wide imaging adoption that will reduce barriers among medical specialties, facilitate increased data sharing and provide clinicians with a unified patient view across the continuum of care – regardless of whether patient data is from a hospital, clinic, imaging center, specialist, primary care provider, physical therapist or psychiatrist.
By adopting a forward-leaning, vendor-neutral, best-in-class platform architecture, radiology groups can mitigate the challenges of increased interoperability, quality and competitive pressures – all while improving productivity. Cloud-based technologies can eliminate the need for huge capital outlays while optimizing operational and clinical efficiency, and simultaneously improving physician productivity, patient care and compliance.
In the past few years, the federal government has released a number of mandates regarding interoperability and patient outcomes — rewarding groups who have implemented various programs with payments, and assessing fines to groups which did not. Moving forward, radiology groups will have three options when it comes to the rapidly changing requirements imposed on them:
- Be noncompliant with new legislation
- Invest massive amounts of time, energy and capital to build their own systems
- Adopt a cloud-based suite of technologies from a trusted integration partner to remain compliant and improve productivity
The Medicare Access & CHIP Reauthorization Act (MACRA) requires healthcare imaging professionals in the Medicare program to order advanced imaging studies compliant with clinical decision support (CDS) software based on appropriate use criteria (AUC) by January 1, 2017. This deadline has since been pushed to summer 2017, but essentially mandates that clinicians ensure the right procedure is being done at the right time by the right physician.
This initiative aims to reduce overutilization and costs while improving patient outcomes, and it will be critical for physicians to comply with this legislation to avoid noncompliance issues. Should the Centers for Medicaid and Medicare (CMS) find inappropriate use when collecting and tracking the CDS data, or find that groups have not implemented this software to begin with, the offending physicians will not be reimbursed. Noncompliance will also put groups in jeopardy of losing their contracts to practices who do comply.
As medicine transitions toward interoperability and greater connectivity, radiology groups will need to remain at the forefront of this movement and prepare for the legislative and technological changes ahead.
Build Your Own?
Radiologists today face a host of challenges — a “perfect storm” if you will — including managing multiple contracts, distributing work efficiently, improving report turnaround times and integrating with multiple systems of hospital and health system customers.
The integration of disparate PACS and dictation systems can cost radiology groups time, energy, reduced productivity and capital investments in hardware and software updates every few years as technologies continue to evolve. In addition, systems often fail to integrate, forcing radiology groups to turn away potential business due to connectivity issues. In an era of increased competition, radiology groups cannot afford to lose valuable customers due to outdated technologies.
While building their own systems may give groups the customization they desire at a given point in time, the construction and maintenance of their own platforms may come with too high a price tag and may not provide the flexibility they need to avoid becoming obsolete as technology continues to evolve.
The evolution of cloud-based, best-in-class, vendor neutral technologies has allowed groups to implement their systems quickly and cost-effectively, customize their workflows, and ensure their systems are primed for the future of enterprise imaging by being highly agile and adaptable.
This cloud-based approach provides radiology groups a modularized solution that is both cost-effective and well-equipped for future changes in both radiology, enterprise imaging and technology itself. Today’s solutions are also offering a more manageable pay-as-you-go model, allowing groups to avoid costs of more than $1 million in up-front capital investment costs, personnel and ongoing annual charges. These cloud-based solutions help groups easily add and administer contracts, monitor quality and productivity, and operate without the burden of software, hardware and IT infrastructure costs.
Enterprise imaging is the foundation of a truly interoperable healthcare system that connects providers, patients and payors across the continuum of care to ensure optimal results. Many of the changes within healthcare are moving toward an outcomes-based reimbursement model that will require greater connectivity among providers.
In answering the common “Buy or Build” question, a recent study by a national consulting group, Constellation Research, concluded the following: “Organizations must determine if they should buy a suite of products from a single vendor or piece together tools from multiple vendors in a “best-of-breed” approach. While there are benefits and challenges to both options, Constellation believes that overall a suite approach remains the correct decision for most organizations.”
This column was made possible by a partnership between ADVANCE and RBMA. For more information on RBMA, call 888.224.7262 or visit www.RBMA.org.