No area of medicine has been untouched by the huge advances in technology in recent years. At the same time, patients are shouldering more of their healthcare costs, and fee-for-service reimbursement structures are starting to be replaced by value-based reimbursement. Radiology as a specialty is undergoing many changes as a result of technology and shifting attitudes about healthcare funding.
In coming years, radiologists will be required to do more than simply interpret images. Rather, they will be charged with managing how radiology services play a role in tomorrow’s medical care delivery paradigms. As fee-for-service gives way to value-based medicine, radiology services are expected to change from being a profit center for facilities to being an area that drives cost savings. It makes sense, because medical imaging assists with rapid diagnosis and helps caregivers function more efficiently. Following are some of the directions radiology and its associated technology is going.
Scorecards and Dashboards
“Scorecards,” though you may hear them called by other names, are already fairly common in radiology. A scorecard could be one of any number of retrospective tools that is associated with key performance indicators (KPIs) and helps radiology services providers understand how well they are fulfilling their goals. Scorecards are strategic tools for providers of radiology services.
Dashboards, on the other hand, are more tactical. A radiology services dashboard, for example, provides real-time awareness of how radiology systems are being used. Ideally, a dashboard should let radiologists use what they’ve learned from their scorecard to plan better radiology services. Dashboards are not as common in radiology services yet, because they have to be ingrained into workflows, interoperate with other systems, and they need to be liked enough by radiologists to be used. Ultimately the purpose of scorecards and dashboards is to provide feedback so that performance and value improve over time.
Electronic Medical Records and Clinical Decision Support Systems
Electronic medical records (EMRs) reduce barriers to reviewing patient files. Integrated with computerized physician order entry (CPOE) systems, EMRs make the ordering of radiology services more efficient. When clinical decision support (CDS) systems are integrated with EMRs and CPOEs, better decisions can be made faster about which radiology services are appropriate. Some commercial CDS systems create “appropriateness scores” based on appropriateness criteria developed by healthcare providers.
Early adopters have documented reductions in exams required due to more careful decision-making about which radiology services are most appropriate for a given patient and clinical situation. CDS technology is expected to gain traction in coming years, because starting in 2017, appropriateness criteria will be mandated by law, and reimbursement for advanced radiology services performed for Medicare and Medicaid patients will only occur when appropriateness criteria are verified. It is likely that private insurers will develop similar requirements.
Virtual Reality Radiology Training Modules
The technologies discussed above are about provision of radiology services, but how might technology be used in training radiologists of tomorrow? Virtual reality could play a larger role as systems become more sophisticated. Simulations may be used to train students and residents in basic interventional radiology services. Training modules will include immersive “guided tours” of designated environments or procedures. As trainees work through virtual reality training modules, key information on procedural steps is given interactively. Trainees will, for example, have the ability to select virtual objects in their environment and request clarification in real time.
Training modules already under development cover basics like understanding the interventional radiology suite, setting up a standard interventional radiology tray, performing quality and safety checks, and performing procedures like CT-guided biopsy and angiograms. After completing training modules, users are asked to rate their experience and test their knowledge, both for charting their own progress and to allow virtual reality developers to improve their products.
Technological advances in radiology services are necessary as healthcare reimbursement models change and new efficiencies must be developed to contain costs. Scorecards and dashboards, which are already used in other professions, are being adapted to radiology so that providers can choose the right imaging technique for the patient and the clinical need and avoid duplicative or unnecessary radiology services. Electronic medical records and clinical decision support systems will help physicians determine the most appropriate radiology services to order, saving time and resources. Virtual reality technology is expected to create more immersive training modules for tomorrow’s radiologists.
Dr. Michael Arch – Pediatric Radiologist
At SteleRAD, our radiologist owner-operators have the clinical and technological skills South Florida facilities need to ensure outstanding radiology services for their patients.
Dr. Michael Arch is one of SteleRAD’s Board-Certified specialists in Pediatric Radiology. He has published works and made presentations about different technologies in radiology, specifically about scan parameters used by pediatric radiologists. Dr. Arch completed his fellowship at Duke University Medical Center. To learn more about Dr. Arch and the SteleRAD Pediatric Radiology team, click here.