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Threats and Opportunities Just when you thought you had PACS worked out in your organization, Paul Chang, MD, FSIIM steps to the podium and reminds you that isn’t good enough anymore. “The real issue is not trying to deliver images to radiology but throughout the enterprise,” Chang told the audience in a session on PACS and EHRs at the Society for Imaging Informatics in Medicine (SIIM) annual meeting in Minneapolis earlier this month. This ability to distribute images across the healthcare enterprise will ultimately mesh with the images’ inclusion in a patient’s EHR. Increased ability to access and distribute images, radiology reports, and other data from patient records present both an opportunity and a threat to radiologists. The threat is familiar. Digital imaging and IT enabled a boom in remote reading that launched the teleradiology industry and increased radiologists’ ability to compete with one another. Separating the radiologist’s physical presence in the hospital from the radiology report has the effect of reducing radiology services to images and reports. This fosters the trade of images and reports as a commodity, sold on the best price. Radiology groups are contemplating whether and how they should address that threat. The commoditization threat coupled with anticipated declines in technical component reimbursement, particularly for outpatient facilities, puts greater competitive pressures on groups. The opportunity may come from the next generation of healthcare IT that may transform medical practice the way computerization has transformed other industries. Healthcare lags far behind other industries in its effective utilization of IT. Change gave an example using Amazon.com, where the customer accesses the site using only a Web browser and completes a purchase. Amazon’s network manages a secure purchase involving numerous computer systems interacting with one another, including its own site, the product manufacturer’s site, inventory management, shipping, and credit card payment. In the healthcare environment, Chang’s example would be the equivalent of a radiologist receiving an exam order, verifying insurance eligibility, scheduling the exam, reviewing the patient’s medical record and the acquired images, reporting back to the patient’s referring physician, and then coding and submitting a clean insurance claim— using only a Web browser. Compared with other industries, Chang said healthcare software systems are at an “adolescent” stage in their development, particularly in terms of interoperability. He said imaging organizations must demand IT capabilities similar to those deployed in other industries. Such change must come on two fronts: radiology’s willingness to change how it works and its willingness to demand IT capabilities on the same that level as other industries. — Jim Knaub is editor of Radiology Today |
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