As radiologists come under more pressure to improve performance in a value-based care environment, they’ll have to adopt information technology to help them deal with new challenges for increased efficiency.
While radiologists have used digital systems for many years in viewing images and creating reports, they’ll have to become adept at new IT systems that will help them demonstrate their value to healthcare, says Paul Chang, MD, professor of radiology and vice chair of radiology informatics for the University of Chicago Medicine.
The emergence of value-based care “is a huge opportunity for those of us in radiology,” Chang says. “We will no longer be valued just for reading images. But we have to prove we’re doing the right thing” in treating patients.
Under fee-for-service reimbursement, radiologists “could get away with optimizing quality or efficiency—you didn’t have to do both,” Chang says. “In this new world, you will need to optimize quality, efficiency and patient safety. To do that, radiologists will need to leverage IT.”
In a presentation at the recent conference of the Radiological Society of North America, Chang said radiologists will need to use IT to reduce variability, and use it in such a way to reverse common trends that are currently working against quality. For example, Chang says many healthcare organizations have put themselves in a place where they “rely on humans remembering to do the right thing; it’s unacceptable to be dependent on one person—that introduces variability. It’s more important to rely on data driven workflow rather than retrospective review.”
For radiologists, it’s important to consider ways to use IT tools as part of “a complete quality-driven workflow,” he adds.
That is what’s helping improve quality in radiology at Penn Medicine, says Tessa S. Cook, MD, director of its 3D and advanced imaging laboratory as well as director for the Center for Translational Informatics.
The organization is increasing its use of interoperable methodologies to improve information sharing, as well as the exchange of radiologists’ reports and other data.
At Penn, the organization built an in-house system that used interoperability to build reports and use information to identify people for whom radiologists identified concerns that should be followed up. In a manual workflow before using the system, a radiologist might call a physician and suggest that a patient may require a follow-up study. But without a way to take the existing report data and patient data and send them with an electronic message to the ordering physician along with the recommendation, it’s likely that the case won’t be effectively handled.
To improve the transfer of information and care continuity, Penn Medicine built an in-house system to transfer the information. The Penn effort used guidance from the Integrating the Healthcare Enterprise project (IHE), which offers integration profiles meant to enable the transfer of information from various disciplines within healthcare organizations.
“Scheduled workflow is one of the biggest successes to come out of IHE,” Cook says. “There is now more consistency throughout the care cycle.” Healthcare organizations need to pressure IT vendors to get better access to the information that’s needed for IT integration efforts, she adds.
Demands on radiologists are changing because of economic forces such as value-based care, forcing them to become participants in quality improvement efforts and to use IT as a tool to improve results, Chang says.
“We now have to improve value, and the only way to do that is leverage IT to enhance what humans can do,” he says. “We will no longer be valued just for interpreting images; the goal is now measureable improvements in efficiency, productivity, costs, achieving metrics, quality and patient outcomes.”
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