How Imaging Interoperability Creates Value For Emerging Healthcare Models
By Matthew Michela, President and CEO, lifeIMAGE
Value-based imaging, according to the American College of Radiology’s Imaging 3.0 initiative, is the path to moving radiology as a specialty out of the fee-for-service modality and into the care-quality improvement and patient-experience enrichment model upon which reimbursements for all healthcare providers will soon be based.
Value-based reimbursement is the destination for healthcare. Having an enterprise imaging strategy that breaks down data silos and promotes the free flow of imaging information throughout the enterprise and beyond — to physicians outside the firewall involved in, for example, consults and second opinions — is essential to accomplishing value-based reimbursement. Instead of continuing to create duplicate, unnecessary tests and exposing patient populations to unneeded radiation, imaging needs interoperability. Imaging 3.0 will improve patient safety and satisfaction, boost care quality, and create value in a variety of new ways.
Importantly, more than just radiology needs imaging interoperability. Scores of specialties today use imaging, from oncology and neurology to emergency medicine and dermatology and beyond. Health system enterprise managers have a difficult time keeping track of all their systems in an era of mergers and acquisitions, and the purchase of local independent practices. So it’s a tall technical order, creating value in imaging. But it can be done and it must be done; just in time for the new MACRA rules that ask providers to search for previous CT studies, and to make CT scans available to patients and providers for 12 months.
Enterprise Imaging Strategy Accommodates All Workflows
A proper enterprise imaging strategy comprises the right tools for each “-ology” to do its work — interpretation and review of images — with a user interface that gives them the quick access, resolution, and perspective covering the needs of those specialists on a given network.
In practicality, each hospital and health system has a different referral network, different clinical needs, and are each scaled to their particular patient base. To tailor an imaging strategy to their specific enterprise, IT leaders need to first catalog all provider needs: where are the specialists who need images? Radiology, cardiology and oncology are the usual suspects. Then emergency medicine, intensivists, and referring physicians.
The various groups might not need deep-featured imaging tools, but they still need timely access to images and the interpreting providers’ reports to make real-time clinical care decisions. Make a list to get a handle on the scope of the imaging strategy that facilitates collaboration between physicians — preferably real-time — to let them look at the same image on their respective monitors at the same time to allow real time collaboration vs verbal descriptions.
How IT Staff Can Steer The Strategy
IT staff execute the solutions for clinical problems, but that can only happen within the context of working closely with physicians who are using the network. Talk to the specialists who are using the imaging systems and tailor an enterprise-wide implementation that solves their specific problems so they can deliver more efficient care.
True interoperability comes only with a hybrid network-and-cloud model. The network side facilitates image sharing within the firewall, and a cloud component gives providers outside the firewall secure access to needed imaging studies. This enables physician collaboration outside of a network for referrals and second opinion reviews.
Once all these details of a health system’s imaging needs are understood, vendor selection can begin. Whatever technology vendor your organization selects, carefully choose the standard interface physicians will be using to interpret and review clinical images, and make sure not only that the correct features are built in, but that it’s intuitive to use in all of the clinical workflows. Usability is key not only to function, but to get that physician buy-in that makes an enterprise imaging strategy a success.
Getting The Buy-In With An Appropriate Rollout
Chances are, if IT staff has not yet set up a formal imaging workflow for emergency medicine and the stroke neurologists, those specialists probably have devised an ad-hoc workflow to share images. Clinicians for which treatment time is crucial will benefit most when it comes to choosing the order of rollout in an enterprise imaging strategy implementation.
Radiology remains a key entry point for images on a network. Understanding this dynamic is a crucial facet of the enterprise imaging strategy. It’s incumbent upon IT to support medical imaging’s needs, but there is a shift where there are more specialties whose imaging access and use need to be addressed. Once all of the back-end technical issues of an implementation are addressed, imaging repositories become an open system with a common viewer, integrated with the electronic medical record.
While building enterprise imaging strategies now falls on IT leadership — because such strategies span specialties far beyond radiology — veteran medical imaging leaders should sit on planning committees for developing implementations.
In summary, value-based imaging will only happen when interoperability initiatives reach far beyond radiology, under the steerage of those guiding enterprise IT. Bringing true value to a traditional fee-for-service structure takes vision, planning and leadership, but there will be payoff as healthcare move into a quality-based system focused on patient needs and outcomes.