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Health care in the United States is evolving rapidly, and Bruce Lehrman, MD, president of Diagnostic Imaging Inc (DII), Philadelphia, Pennsylvania, believes that radiology is in the forefront of change in the industry. “I’ve never seen the landscape in health care changing more rapidly than it is now, and leading that change is radiology,” he says.

DII is no stranger to evolution; in the past two decades, the practice grew from 10 radiologists to 60, and on September 7, 2011, it completed a merger with Virtual Radiologic (vRad), Minneapolis, Minnesota. “Our practice now reads for many different hospitals and health systems, and that means we’re using multiple PACS and RIS platforms,” Lehrman says. “vRad will provide us with a unified worklist to connect all of our sites, allowing us to provide a higher-quality product more efficiently.”

Mergers in imaging are taking myriad forms; in March 2011, Southwest Diagnostic Imaging of Dallas, Texas, joined forces with three other local radiology groups to form Radiology Associates of North Texas. With 110 radiologists on staff, Radiology Associates of North Texas is now the largest radiology practice in the state&emdash;and one of the largest in the nation.

In the May 2011 issue of Journal of the American College of Radiology: JACR, the ACR® Future Trends Committee¹ published a paper focused on helping radiologists manage the transition to value-based purchasing. The paper outlines roles for radiologists that might be helpful in successfully participating in accountable-care organizations (ACOs).

Richard Duszak Jr, MD, says, “The earlier radiologists get on board with ACOs and the more energy they exert, the likelier they are to be successful.” Duszak, a diagnostic radiologist with Mid-South Imaging & Therapeutics (Memphis, Tennessee) is a coauthor of the paper. “ACOs may not be exactly the model we’ll ultimately go to, but they are a predictor of the fact that we are transforming from a fee-for-service system to value-based purchasing,” he adds.

Although how future ACOs will be structured remains ambiguous, Duszak predicts that hospitals and/or health systems will make natural stewards of the process. "In theory, there is absolutely an opportunity for practices to be at the center of an ACO," he says. "Moving to practice, however, becomes more challenging."

Health IT continues to advance at a breakneck pace, and recent developments hold enormous potential for enhancing the productivity of both radiologists and the physicians who refer to them, according to Rick Jennings, CTO of Virtual Radiologic (vRad), Minneapolis, Minnesota. Jennings shared his perspective on some recent developments in health IT during “Accelerating the Adoption of mHealth: Strategies and Sustainable Business Models,” a panel held on August 15, 2011, at the Institute for Health Technology Transformation’s iHT² Health IT Summit in Seattle, Washington.

“This broad wave of technology is rolling into health care with two missions: improving care and reducing costs,” Jennings says. “Patients and physicians are demanding easier ways to share information, and there are proven technology approaches to facilitating that.”

Under increasing pressure to do more with less, both radiologists and referring physicians are seeking technologies that will enable them to be more productive while improving the quality of care. "Reimbursements are declining, so the only way a radiology practice can maintain its income is to be more productive," Jennings says. "We have very focused views on how to improve radiology, and we believe we are transforming it through the virtual practice."

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