There’s never been more turbulence —and opportunity, within healthcare. It’s a perfect storm of a changing legislative landscape, changing patient behavior, and disruptive new technologies like cloud computing and artificial intelligence.
If you’ve been wondering what it all means for radiology, then you’ve come to the right place. On a recent special webinar event, in partnership with HIMSS, Dr. Safwan Halabi, a pediatric radiologist and a fetal radiologist who also runs the informatics portion of imaging at Stanford Children’s Health, shared his insights into the trends he’s seeing. He was joined by Tyler Martin, the Executive Director of Ambulatory Network Operations at New England Baptist Hospital (NEBH), and Morris Panner, CEO of Ambra Health.
During the event, we took the pulse of the industry, polling attendees on their perspective of the radiology and broader healthcare landscape.
Top of mind was the adoption of value-based care. It’s no secret that healthcare providers are on the move from a primarily fee-for-service model, to value-based care, with shifting incentives to change provider behavior. Reimbursement is changing to focus on quality of care, like perhaps not doing unnecessary additional procedures such as redundant imaging.
There are challenges however to implementation that are both logistical, and others based on the shifting sands of the current legislative environment. In terms of practical implementation, the panel noted that there are barriers to adoption around metrics. Dr. Halabi noted that the Medicare Access and CHIP Reauthorization Act (MACRA), and Merit-Based Incentive Payment System (MIPS) legislation all create the need for better metrics, benchmarking and performance management. The challenge however, is how to determine what the right value-based metrics are, the milestones to track, and how to compare them with geographic and outcome based benchmarks.
A major driver for value-based care has also been legislative, with the roll-out of the Affordable Care Act (ACA). However, with legislation in flux, there have been question marks as to whether it will slow down, or stop the adoption of value-based care. When we polled attendees however, 90 percent indicated that value-based care is here to stay, while indicating that the rigorous legislation surrounding it may perhaps be moderated a little.
Noted by our panelists, elevating patient experience is a significant area of focus, as patients get increasingly engaged in healthcare decisions.
The panel shared several initiatives around patient satisfaction. One area is for referral centers is improving image sharing and interoperability between providers so that everything is keyed up by the time the patient is seen, and the physician has already had ample opportunity to review the imaging that was performed elsewhere.
At New England Baptist, Tyler sees patient empowerment as a major opportunity, and they’re making it easy for patients to upload their outside imaging from CD, whether at home or office directly to NEBH’s website —minimizing repeated imaging studies, and reducing the chance that patients arrive at the hospital without their imaging.
Patient-centered radiology is a hot topic with a gradual move towards delivery of imaging directly reports to patients. One area the gap is closing in the patient journey is the communication between the different providers in the health system, referring physicians, and clinicians. And with the growth of patient access to reports, the panelists noted that curation is becoming key ― to make reports more patient-friendly, and easier to understand, a concern that’s also often echoed by patient panels.
Cloud VNA is being embraced by providers in several different areas, from easing of image access and sharing, to improving business continuity, and disaster recovery.
An strategy for adoption of cloud VNA is a hybrid approach, with Tyler noting that they use a traditional PACS solution within the department at NEBH, but rely on cloud-based VNA to get imaging out to the rest of the world. It’s easier to manage, and it costs a lot less to provide access, without the need for complex desktops and VPN connections.
Tyler even sees opportunities to bypass the PACS system completely in some cases, where modalities can all send to the cloud VNA, so radiologists can at least still give preliminary reads, or a full read if they need to, while waiting for the traditional PACS system to become available.
Healthcare providers have been incentivized by series of government legislation from the American Reinvestment and Recovery Act (ARRA), to the Health Information Technology for Economic and Clinical Health Act (HITEC), and now the Protecting Access to Medicare Act (PAMA), to deploy Clinical Decision Support (CDS) systems.
In our poll, 78 percent of attendees saw multiple opportunities to apply intelligence to healthcare, including improving workflows, monitoring patient follow-up, and linking radiology & pathology reporting.
The panel noted that new technology such as machine learning and AI may be used to augment decision making. Dr. Halabi sees opportunities for aiding in detection of disease, either with imaging, or even prior to imaging, by predicting which patients really do need to be seen first. For example, who needs a mammogram, or at what age should they get it.
Tyler sees other ways to apply the latest technology, to use intelligence and automation to improve workflows. By streamlined image routing at NEBH, getting images in, routing them instantly to the right departments and people, they’ve improved both administrative and physician efficiency.
To learn more about radiology trends in 2017, and hear from Dr. Safwan Halabi, Tyler Martin, and Morris Panner first hand, check out the recording of the webinar.