Radiology departments have an important part to play as healthcare becomes focused on value-based care. As providers work to improve care without raising costs, they’re seeking ways to involve previously siloed departments like pharmacy and radiology on the care management team.
As radiology executives prepare for greater involvement, their first step should be data collection, including the impacts of imaging studies on treatment. They should also prepare detailed information on the cost effectiveness of imaging studies for a wide variety of conditions and circumstances. For example, the paper “The uncritical use of high-tech medical imaging”, published in the New England Journal of Medicine, stated that imaging tests are most valuable when the probability of disease is neither very high nor very low but in the moderate range.
Executives must also show the downside of decreased radiology utilization. In some cases, lower utilization results in overall cost increase due to delayed discharge, unnecessary admissions and even inaccurate patient assessment, which can have extreme cost and care impacts.
With robust data on hand, there are three important, proactive steps radiology executives can take to make their departments more appealing as they work toward value-based care:
1. Improve communication between primary care physicians and radiologists. FierceMedicalImaging editor Mike Basset has written extensively about the importance of clarity of language on radiology reports. He noted that in a survey, primary care physicians said the second most important component of radiology reports (after diagnostic accuracy) was clarity of language. Specifically, the
American College of Radiology says physicians want reports that:
- Avoid radiology-centered jargon
- Don’t use different terms to describe the same condition
- Limit extraneous information
- List the radiologists most consequential findings in order, from the most to least important
- When appropriate, provide supporting information about why the radiologist believes additional imaging studies are necessary
In addition, a clear strategy and program that enables the radiology team to connect with referring physicians can ensure that the radiology department or group becomes a more highly valued part of the care team.
2. Streamline platforms, reports and workflow. There are proven costs savings in transitioning from facility-based solutions to a single, enterprise medical imaging platform. Likewise, having reference or flagged images and more structured content in reports (as opposed to only free text summaries) can lead to significant efficiency gains for providers. Broad adoption of structured reporting in will be evolutionary, but there is no reason not to start now with the modest goal of making reports easier to “digest.” And, by adding an intelligent, flexible workflow engine you can help bridge the gaps in communication ultimately saving money, improving adherence to patient safety standards and facilitating continuous process improvements.
3. Facilitate a culture shift. Ultimately, radiology execs must become an engaged member of the team. At a minimum, that might mean picking up the phone to speak with a PCP whenever they see an ordered exam that may not make sense. In the end, radiologists would be well-served to transform their role from service provider to key trusted advisor on the team for both diagnostics and treatment plans.
Going forward, there is significant benefit to in having radiologists advise when a higher cost study will ultimately save money, demonstrate and document the value of diagnostic choices, strategize on ways to reduce readmissions, improve patient management and focus on value-based care.