Like virtually all health care providers, diagnostic imaging departments are being buffeted from all sides by micro and macro forces reshaping the industry into one based on the value, not the volume, of care. Among those many forces are a decline in diagnostic imaging test volume, lower reimbursement rates for diagnostic imaging tests, pressure to reduce operational costs and unnecessary utilization and higher expectations to improve care coordination.
For many diagnostic imaging departments, the forces have them scrambling to respond as just another cost center within a larger organization. But for forward-looking diagnostic imaging departments, those forces are opportunities to become profit centers that drive improvements in clinical and financial outcomes for themselves, their organizations and, most importantly, their patients.
The opportunities fall into three areas, each with the power to bend those forces in the right direction for all stakeholders along the health care delivery chain.
1. Align diagnostic imaging with value-based care
Diagnostic imaging departments must redefine themselves as critical components in all value-based care models, whether that model is a bundled-payment scheme, a population health management program, a readmission-reduction plan, accountable care organization, chronic disease management or more. No longer should diagnostic imaging departments simply perform a test and send the results on their way while waiting for another test order.
The first step in that transformation is actively and aggressively studying the impact diagnostic imaging has on treatment plans, outcomes and costs for a wide-range of conditions, illnesses and injuries. For instance, research has shown that diagnostic imaging tests are most valuable when the probability of a disease is moderate, rather than high or low.
Once knowledgeable on the role diagnostic imaging plays in treatment plans, outcomes and costs, diagnostic imaging departments, radiologists, technicians and other department staff should align what they know with their organization's larger value-based care initiatives. They can do that in three ways:
Lead: Speak out about the value of diagnostic imaging as part of the care process
Document: Collect, analyze and report data on the before-and-after impact of diagnostic imaging tests on episodes of patient care
Communicate: Talk to patients directly as part of the care team, discussing issues such as quality, safety and appropriateness of care
2. Integrate clinical data from EHRs into diagnostic imaging workflow
Clinicians benefit from access to a patient's medical condition or history when performing a diagnostic test on a patient. Having this information improves the clinician's ability to perform the diagnostic imaging test safely and effectively.
Advances in EHR technology and the ability of EHR systems to send and receive patient information now make it possible to integrate clinical data from patients' electronic medical records into workflow of the diagnostic imaging department. Patient information that should be available to radiologists, technicians and other department staff include:
- History and physical
- Emergency department notes
- Pathology reports
- Surgical history
- Discharge notes
- Laboratory results
- Allergies
- Medications
Such information is critical to interpreting images correctly and making accurate diagnoses. Filters that present the most germane clinical data would mitigate information overload for imaging departments, allowing radiologists and technicians to focus on conditions, images and interpretations. Further, having imaging-relevant patient information from EHRs embedded into imaging dashboards at the appropriate place in imaging workflows promotes operational efficiency. It would save hours of time each week and avoid unnecessary follow-ups or repeat tests.
3. Leverage diagnostic imaging to improve early and accurate clinical diagnoses
One of the biggest drivers of unsafe, ineffective and costly care - all particularly detrimental to value-based care models - is delayed or inaccurate diagnoses. In a September 2015 report, Improving Diagnosis in Health Care, the Institute of Medicine said 5 percent of outpatients each year experience a diagnostic error, and as much as 17 percent of adverse events experienced by hospitalized patients each year are caused by diagnostic errors.
One of the biggest solutions to the problem identified by the report is more effective diagnostic imaging testing. For the departments that perform those tests, that means providing the right image with the right interpretation at the right time. To do that are the following three tactics:
Enable accessibility: Allow images from imaging systems to be accessible to clinicians on a variety of devices in a variety of settings.
Maximize efficiencies: Scrutinize existing imaging workflows to identify opportunities to reduce testing and turnaround time.
Real-time availability: Make images and interpretations available in real-time to physicians anytime, anywhere in addition to on any device.
Other providers never should have to wait on the diagnostic imaging department to see and act on the most relevant image affecting clinical decisions to be made for their patients.
Culture. Technology. Commitment. As discussed above, they are three essential ingredients diagnostic imaging departments need to position themselves as desired clinical and business partners to provider organizations, patients and payers as the transition to value-based care accelerates.
Related: Learn about McKesson's Diagnostic Imaging Solutions