HIT Think

Why organizations need to review their image sharing strategies

While value-based reimbursement offers a new world with better-aligned incentives and the promise of better outcomes at lower cost, for imaging services, this transformation may be rocky.

For the past decade, hospitals and health systems have depended on imaging services to be a revenue generator. But with capitated or bundled reimbursement, more imaging doesn’t add more revenue. In fact, it can hurt the bottom line.

For administrators of imaging services, this is a disturbing development. Much of the imaging capability in health systems has been a direct result of the investments made possible by the revenue generation possible in a fee-for-service payment system. When imaging becomes an expense center instead of a revenue center, that dynamic is likely to change.

So how can hospitals and free-standing imaging services adapt to this new environment and keep imaging services and budgets healthy? By finding ways to get more value from the images, both current and archived, and finding ways to increase the organization’s bottom line beyond revenue generation.

While there are a number of ways to do this, a first step is to ensure that all image data is easily accessible to any member of the care team that needs the image. That isn’t as easy as it sounds, especially if the organization has been part of the recent flurry of mergers and acquisitions. Many health systems and large imaging providers have multiple imaging sites and may have a half for those using proprietary platforms that don’t play well with each other, much less with EHRs and other clinical systems.

Meeting this challenge requires an enterprise-wide image strategy that brings all diagnostic images (and any other unstructured clinical data) onto one platform in a vendor-neutral format. With this foundation, an organization can add amazing capabilities, including integration with multiple EHRs and enterprise-wide business analytics, dose monitoring and collaboration. A vendor-neutral platform takes the friction out of information movement in the organization, enabling physicians and other clinicians to easily access the image studies they need and review them along with other clinical data.

A vendor-neutral platform also reduces cost by avoiding expensive data migration if an organization changes imaging devices.

With health systems and health plans focusing on population health risk identification and stratification, image analytics can offer a big return on investment. An image analytics solution is a relatively inexpensive approach to health risk identification that makes use of existing resources in creative ways. Imaging studies are scanned to identify images with the right physiologic data for analysis. For example, chest X-rays taken for pre-surgical screenings can be analyzed to identify signs of cardiac disease, among other risks.

There are a variety of algorithms currently available to identify risks for cardiac disease, pulmonary disease, osteoporosis, liver disease and more. The algorithms are very accurate, and a growing number of diseases can be detected using this approach. Best of all, it produces critical data without additional imaging studies or physician or patient effort.

The first step is to start thinking about all the image data in an organization as one resource that is used by a variety of people across the enterprise. A successful strategy will address the broad view of patient care, not just a single episode of care.

From detection of disease with new analytics tools to the capabilities to solve patient-specific and population health problems using stored imaging studies of all types, a successful strategy should focus on a platform with the flexibility to gain value now and in the future. The pathway forward is continuing to change and having an advanced vendor-neutral platform builds the capacity for future problem-solving.

The days of having single points of data for patient care decisions is behind us. No one can predict the many ways that digital data may be important in the future. A successful strategy for any enterprise must ensure that the broad definition of clinical data, including image data, is aggregated in a vendor neutral way, is accessible, is highly available and is secure for any new opportunities that arise.

These are some basic action items for organizations that want to get started:

  • Evaluate the current image platform. Is it vendor neutral, or is data stored in proprietary silos?
  • Understand the wide variety of clinical images in use. While most will be DICOM, many hospitals and health systems have other image data (for example, documentation in wound care, ophthalmology and dermatology) that are also part of the clinical record. Those images should also be incorporated into a vendor-neutral platform.
  • Consider using a cloud platform, to gain easier integration of data and to enhance accessibility for off-site viewing.
  • Look for a platform with the greatest ability to adapt to new integration challenges. Integration is critical to getting the maximum value from image data.

One potential resource is, “Enterprise imaging strategy: It’s Not About the Archive, It’s About the Integration,” a white paper compiled by NTT DATA.

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