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The Big Picture
Are You Keeping Up?
By Curtis Kauffman-Pickelle
 I don’t know about you, but it seems to me that the world is moving at a much faster pace these days. Time rips by, dates and events blend together in blurry motion, and the sheer pace of change is accelerating to a point where one needs to be constantly vigilant about staying current with all that affects our daily lives. This is especially true in medical imaging. In this profession, if you stand still, you are actually moving backward.
In our particular segment of health care, medicine combines with economics, technology, engineering, science, and the various social sciences to form a profession where the confluence of these disparate endeavors creates an intellectual’s dream—and a Luddite’s nightmare.
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Investing in Radiology IT: A Three-pronged Strategy
By Cat Vasko
 This article is the first in a four-part series.
Imaging, like the rest of medicine, is experiencing an unprecedented proliferation of IT products. In the wake of IT-friendly legislation such as the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Patient Protection and Affordable Care Act, providers are experiencing more impetus than ever before to invest in the IT necessary to connect them to other providers, to enable them to care for more patients with fewer reimbursement dollars, and to pave the way for their participation in future care-delivery models.
On February 23, 2012, radiology received an additional boon in the form of the CMS proposed rule for stage 2 of the meaningful use of electronic health records (EHRs), which includes a menu-set measure focusing on image accessibility via EHR.
Joe Degati, CTO for Medical Management Professionals, Inc (MMP), says, “Radiology practices have to get on board with industry-wide changes coming from the DHHS, CMS, the HITECH Act, and so on, but when developing a technology-investment strategy for the next 24 or 36 months, the practice cannot just consider its own needs. It also has to consider the needs of the referring physician—and, most important, the patient.”
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Optimizing the MRI Portfolio for Patient-centered Care: Lee Memorial Health System
By Cat Vasko
 Lee Memorial Health System (LMHS), Fort Myers, Florida, offers a wide range of imaging services at its four acute-care campuses and three outpatient imaging centers, including a host of high-field MRI systems. As Mark Williams, director of outpatient imaging, recalls, however, something was missing. “When we looked at our business model, we saw that we had a demand for a patient-centered MRI system,” he says. One of Lee’s outpatient centers had a 0.3T open system that scanned one or two patients a day, but the demand was much higher than the system could accommodate.
“With changing times and reimbursement on the decline, we had to maximize our return on investment,” Williams says. “We decided to replace both of the magnets at this facility with a single high-field open system.”
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Smarter Merger/Acquisition Decisions With Revenue Forecasting: Riverside Radiology
By Greg Thompson
The growing trend of large health systems acquiring outpatient imaging centers from radiology groups can create a stressful situation for all parties involved. It can be especially difficult for a radiology group’s leadership to part with what was once a very lucrative arm of the business, but acquisition offers do not grow on trees.
 Marcia Flaherty, CEO of Riverside Radiology and Interventional Associates, Inc (Columbus, Ohio), faced just such a decision (along with the practice’s executive team) a few years ago. With its business compass always pointing toward the future, the group, which serves 45 locations, ultimately made the decision to part with Riverside Radiology’s outpatient imaging center operation, in a move that they have never regretted.
“We were forecasting that technical revenue would be affected in the future,” Flaherty says. “As we looked into the future, we felt it was an opportune time to enter into those negotiations. We’ve always had strong, mutually respectful relationships with our hospital partners, so having that high level of trust, from the start, made the entire process more manageable for all of us.”
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Tech Assessment for the Radiology Practice: Voice Recognition
By Cat Vasko
The process of evaluating new technology has quickened its pace, but that does not make it any less challenging for a busy radiology practice, Ted Best says. Best is acting director of IT for Carolina Regional Radiology (CRR), Fayetteville, North Carolina, and is president of Xodus Technology Professionals. “The process flow hasn’t changed; what have changed are the tools that we use,” he notes. “One of the key factors in making these projects a success is communication, and using advanced tools such as group exchange servers, instant messaging, and video conferencing have helped us communicate more effictively and move the decisions forward at a faster pace.”
 He adds, however, that radiology practices can still succumb to indecision when evaluating new technologies if project best practices are not followed. Best helped shepherd CRR in its selection of a voice-recognition solution, in a project aimed at enabling the practice’s 21 radiologists to use a unified system, as opposed to the disparate voice-recognition systems in use by CRR’s hospital partners.
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CR in Haiti: Durability and Sustainability
By Cat Vasko
 In the wake of the January 2010 earthquake in Haiti, the US Navy deployed an emergency medical fleet, equipping it with an array of state-of-the-art onboard digital-imaging solutions. iCRco, a manufacturer of imaging solutions, provided these first responders with the ability to obtain DR images and diagnose patients’ problems on the spot using the company’s VertX CR system.
In late 2011, iCRco reached out again, this time to Health4Haiti, a nonprofit organization that had established a presence in the country several years earlier and had been building a clinic in the city of Gonaives when the earthquake struck. Stephen Neushul, CEO of iCRco, says, “When the disaster in Haiti first happened, I knew I wanted to do as much as possible to help, but it was surprising that nobody seemed to want medical equipment—just money.”
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Study Says Importing Outside Images into PACS Decreases Repeat Tests
A new study published this month in the American Journal of Roentgenology adds to the ongoing debate over whether the availability of prior imaging exams makes a difference in utilization. The study found that when physicians had access to outside images through PACS, just 11% of patients underwent repeat imaging tests, compared to 72% when images were not available to physicians. Researchers looked at 267 patients that had undergone CT or MRI imaging of the abdomen within four months.
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Primary Care Docs Largely Misunderstand Stats on Cancer Screening
Most primary care physicians misunderstand statistics about cancer screening, which could lead to increased testing with possibly harmful effects to patients, according to a new survey. The survey, published in the journal Annals of Internal Medicine, presented more than 400 physicians with two scenarios of a hypothetical screening test. In one scenario the effect of the screening test was described as improved 5-year survival and the second as decreased cancer mortality. More than three in four of the physicians surveyed stated that each of the statistics proved the screening saved lives. About half incorrectly said that finding more cases of cancer in screened as opposed to unscreened populations proves that screening saves lives.
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Lead Researcher in HIT Study Defends His Work
The conclusion of the Health Affairs study was simple—as currently implemented, electronic access does not decrease test ordering in the office setting, and may even increase it. The results drew a high-profile critique from Farzad Mostashari, the National Coordinator for Health Information Technology. Lead author Danny McCormick, MD, says he expected some push-back, given the stakes: “I think it’s a study that perhaps flies in the face of common wisdom, and so I think some people are surprised. There’s a lot of people with investments, monetary and other, in the cost savings of health care IT.”
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New Commission to Examine Physician Payment Reform
Former U.S. Senator Bill Frist will co-chair a new commission launched by The Society of General Internal Medicine this week to address issues related to physician reimbursement. Co-chairing the National Commission on Physician Payment Reform is Steven Schroeder, MD, former president of the Robert Wood Johnson Foundation and professor of health and health care at the University of California, San Francisco. The commission plans to meet for a year to discuss the potential impact of health reform, looking at accountable care organizations, patient-centered medical homes and value-based purchasing with the hopes of bringing forward recommendations to Congress.
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MARCH
Building Better Radiology Marketing Programs
Sponsored by the RBMA
March 18–20, 2012
Westin Fort Lauderdale
Fort Lauderdale, Florida
Register >>
Congress on Healthcare Leadership
Sponsored by the American College of Healthcare Executives
March 19–22
Hyatt Regency Chicago
Chicago, Illinois
Register >>
SIR Annual Scientific Meeting
Sponsored by by the Society of Interventional Radiology
March 24–29
Moscone Center San Francisco, California
Register >>
APRIL
AHRA Spring Conference
Sponsored by by AHRA: The Association for Medical Imaging Management
April 3–5
Grand Hyatt Seattle Seattle, Washington
Register >>
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