Evolution of Radiology: Emerging focus on value-based healthcare

With over thirty years experience in healthcare imaging solutions, I’ve seen a dramatic shift in radiology technologies over the years.

This once- film-based field where images were read in lightboxes and stored in air-conditioned warehouses has evolved into digital-imaging infrastructures like picture archiving and communication (PACS) and electronic medical records (EMR) systems.

Now, however, with rising healthcare costs and new government regulations, the focus throughout the supply chain is on cost-reduction and value-based healthcare.

Drivers pushing value-based healthcare

The focus on delivering demonstrable value was evident in my recent visit to RSNA 2012 in Chicago.  The Radiology Society of North America (RSNA) 98th annual meeting  has defined the state of Radiology for decades. It includes the world’s largest radiology OEM trade show showcasing products and services to healthcare providers.  As such, it provides an excellent indicator of industry trends and competitive pressures.

George S. Bisset III, MD of Baylor and Texas Children’s Hospital’s address “Patients First,” emphasized the need to improve the patient experience in an increasingly consumer-driven healthcare environment. He acknowledged that the United States Government’s Affordable Healthcare Act will drive the development of “accountable care” organizations and the “patient-centered medical home.” Bissett also noted the movement toward “value-based healthcare,” delivering better health outcomes at lower costs is increasingly important for state governments now investigating these models.

Radiology has enjoyed a fee-for-service business model for decades by creating diagnostic images to be read which were subsequently kept in archival warehouses. PACS products initially focused on replacing film (and the air conditioned storage) with faster-access digital archives. However, they added costs instead of removing them. These PACS systems then migrated into enterprise solutions by integrating with EMR systems.

There is also the added challenge of new reimbursement models requiring radiology providers to manage the imaging process rather than just reading images — a change dubbed PACS 3.0.

In this new model, diagnostic radiology is viewed as

a cost sink. It must deliver value and improvements must be quantifiable. Any value proposition will be measured in terms of safety, quality, and efficiency. New stakeholders such as third-party payers are increasingly demanding accountability and data. For example, the allowable reimbursement rate for MR/CT procedures has decreased so providers must mandate increased efficiency across the board.

Solutions leading the pack in creating value-based healthcare

Worklist management products were created to help streamline a radiology practice’s incoming workflow from exams read by the radiologist to managing images and more. 

The industry is recognizing that PACS is isolating the radiologist from the patient and his/her peers. Worklist management solutions provide a “healthcare package” for optimal reading in a highly-productive environment (cost effective metrics for the provider, profitable for the radiologist).

These solutions provide collaboration tools (think realtime video), something currently missing and may end up providing metrics, essentially becoming a marketing tool. And one can foresee that these systems will have requirements for enterprise image sharing, patient-centric data sharing and new datasets (see Paul Chang, MD, RSNA2012).

How Dell can help

As the industry embraces this need, Dell OEM will continue to see new opportunities. One area where demand seems likely to increase is for leading-edge, power-efficient Dell servers — especially for the EMEA markets.

Dell OEM XL products provide superior lifecycle management capabilities that reduce validation expenses and complexity for the OEM — this is especially useful in highly-regulated industries like healthcare. Additionally, our consultative approach provides a holistic services and hardware environment that is more secure, scalable and reliable to help better ensure healthcare providers can continue to show demonstrable value and manage costs.


John Groezinger

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