Feature | July 03, 2014 | Steve Tolle

Today’s Key to Medical Imaging Success

Medical imaging providers are looking for a strategy to streamline workflows, enhance referral networks, increase referrals and better manage imaging appropriateness

In today’s healthcare environment, longstanding, volume-based models of healthcare delivery are giving way to models where payers are tightening their purse strings and putting a greater emphasis on treatment value. Medical imaging providers are increasingly looking for a strategy to streamline workflows, enhance referral networks, increase referrals and better manage imaging appropriateness. Advanced interoperability is that strategy.

What is Advanced Interoperability?

Like an enterprise imaging strategy, an advanced interoperability strategy consists of three major components — a vendor neutral archive (VNA), universal viewing access, and cloud-based image storage and sharing capabilities — but also includes one more key component to complete the process. 

The VNA serves as a centralized “storage bin” to save and manage images across multiple specialties within a health system regardless of which department they originate. This gives providers within the system fast access to images — especially images from prior visits — and enables them to provide treatment plans more efficiently for improved patient care. The second component, a universal zero-download image viewer, enables providers to access images and reports for every patient within a facility in real time. Thirdly, storage and sharing capabilities built into the universal viewer offer the secure convenience of viewing new and archived files in a single-user interface. 

Advanced interoperability takes it one step further beyond enterprise imaging with the presence of a fourth component: an underlying imaging infrastructure and a narrow network for imaging that enables providers belonging to various healthcare systems to integrate and share information with different electronic health records (EHRs). To some degree, many imaging centers already have some level of integration with their most important referring physicians. For example, imaging centers that receive a majority of their referrals from certain oncology or cardiology practices have already invested and built interfaces to exchange information.

However, what most haven’t built yet is integration with everyone else — the entire community of physicians outside their own four walls. Today’s healthcare ecosystem for information exchange really is much like banks in the early days of ATMs, which at that time could only share information with ATMs belonging to the same bank. It wasn’t until later that an infrastructure was put into place allowing ATMs of different banks to transfer funds and exchange information with each other. 

For true interoperability to take shape, the next phase of exchange must enter a new era where technologies and networks enable healthcare providers of any health system to safely and securely exchange patient data, without requiring them to completely replace their existing EHRs. This can be done by layering new solutions around existing investments to complement the technologies that providers already have in place. Automated report delivery to distribute images and reports directly into a referring physician’s EHR outside their four walls is possible through an advanced interoperability strategy. 

Benefits of Leveraging Advanced Interoperability

Multiple reasons exist for hospital-based and freestanding imaging centers to implement an advanced interoperability strategy for appropriate imaging and clinical decision support. Opportunities include reduction in unnecessary imaging studies, streamlined workflows, growth of referral networks and improvements to the bottom line. 

Reduction in Unnecessary Imaging, Streamlined Workflows

According to The Advisory Board Co., some 800 million medical imaging exams are performed each year in the United States, with hospitals and freestanding imaging facilities each handling about half of those examinations. Yet, statistics show that about a third of all medical imaging scans are unnecessary, and that some $26 billion is spent annually on redundant imaging alone in an overall $100 billion diagnostic imaging market.

As value-based care reform continues, it is expected that payers will continue to focus on appropriateness of imaging. Most recently, President Obama signed legislation that introduces a new clinical decision support mandate for Medicare starting in 2017. The Protecting Access to Medicare Act of 2014 introduced a one-year delay for ICD-10 implementation as well as a new mandate that will impact high-cost diagnostic imaging utilization. Under the law, physicians will become required to use clinical decision support tools as part of the order-entry process to help validate the clinical need for the requested test. Now, once a test is ordered, it will be critical that the clinical decision support information not only be transmitted to the imaging provider but also be included in the final report back to the ordering physician. This “closed loop” imaging process is essential to meeting both the letter of the mandate and improving referral coordination.  

By streamlining the workflows and eliminating many of the time-consuming calls associated with obtaining pre-authorization, advanced interoperability promises to dramatically reduce the cost of unnecessary and inappropriate imaging. More importantly, this makes it easier to follow clinical decision support requirements and imaging appropriateness for improved patient care.

Growth of Referral Networks

Developing strong, close relationships with referring physicians will be a key factor in ensuring the survival of imaging providers in the new healthcare environment, especially as physician expectations rise with the use of EHRs and computerized physician order entry requirements. The Centers for Disease Control and Prevention reports more than 78 percent of physicians are now employing EHRs, and more than half of these physicians have signed on to Meaningful Use (MU) for the stimulus funds provided by the program.

Leveraging an advanced interoperability strategy is a key way for medical imaging providers to reach and engage these providers. It enables the imaging providers to promote themselves as the easiest hospital or imaging center to do business with when it comes to accepting electronic orders, returning reports and results directly to the referring physician’s EHR, as well as meeting other key aspects of Meaningful Use Stage 2 (MU2).

Minimized Referral Leakage for Bottom Line Improvement

On any given day, hundreds of thousands of physicians are referring patients to some 5,000 hospitals and 6,000 imaging centers across the United States, yet not all of those patients will actually undergo their prescribed tests. While there are more occurrences of patients failing to fill prescribed medications, patients don’t always get their images performed for a variety of reasons, such as they can’t afford to pay for the tests, they don’t understand why they need them or they are simply scared. 

In addition, hospitals are constantly managing the high numbers associated with affiliated or employed physicians commonly referring patients to non-affiliated imaging providers. The Advisory Board Company indicates that the average 200-bed hospital loses about $20 million in such referral leakage each year. A solid advanced interoperability strategy can help to alleviate the impact of both patient non-compliance and referral leakage by alerting providers to the failure of a patient to obtain the exam or of a non-affiliated imaging provider earlier in the process. In fact, one health system turned such referral leakage into profit, resulting in $1 million of referral revenue. 

Healthcare is clearly in the midst of transitioning from a time when test volume reigned supreme to a time when quality of patient care and the value of any given test or procedure will rank as key indicators of a provider’s quality of care. 

Leveraging an advanced interoperability strategy that promotes the easy and efficient exchange of clinical data among providers from varying systems and enables healthcare organizations to reduce costs, increase referrals and meet MU2 requirements is critical to ensuring imaging provider success in this new era of healthcare. 

Steve Tolle is chief strategy officer at Merge Healthcare.

Related Content

ScImage Awarded U.S. Government DIN-PACS IV Contract
News | PACS | August 16, 2017
ScImage Inc. was recently awarded a new DIN-PACS IV (Digital Imaging Network/Picture Archiving and Communications...
Neighbors Emergency Center Selects Novarad PACS/RIS
News | PACS | August 15, 2017
August 15, 2017 — Novarad Corp.
Sponsored Content | Whitepapers | Enterprise Imaging | August 11, 2017
All around the world, regulatory requirements and market forces are driving a growing demand for higher-quality, more-...
RSNA Announces Pediatric Bone Age Machine Learning Challenge
News | Artificial Intelligence | August 10, 2017
August 10, 2017 — The Radiological Society of North America (RSNA) is organizing a challenge intended to show the app
Xavier University Announces Healthcare Artificial Intelligence Summit
News | Artificial Intelligence | August 07, 2017
Xavier University has launched the Xavier Center for Artificial Intelligence (AI), a pioneering effort to accelerate...
Fujifilm Launches Synapse PACS Version 5
Technology | PACS | August 03, 2017
August 3, 2017 – Fujifilm Medical Systems U.S.A. Inc.
The team from Smart City Networks, the first corporate donor for the HIMSS Steve Lieber Innovator Scholarship

The team from Smart City Networks, the first corporate donor for the HIMSS Steve Lieber Innovator Scholarship, came together during HIMSS17 for the check presentation. From left to right: Tim Overall, general manager; Marty Rubin, chief executive officer; Steve Lieber, HIMSS president/CEO; Frank Loyke, senior event coordinator; and Jennifer Way, assistant general manager

News | Information Technology | August 01, 2017
The Steve Lieber Innovator Scholarship, sponsored by the HIMSS Foundation, recognizes the leadership and passion for...
Sponsored Content | Videos | Analytics Software | July 28, 2017
Woojin Kim, M.D., chief medical information officer, Nuance Communications, explains how analytics solutions can help
Nuance Restores Service to Majority of eScription Clients Following Malware Incident
News | Information Technology | July 28, 2017
Nuance Communications Inc. provided an update on its restoration process following the previously reported June 27,...
Agfa Receives FDA 510(k) for Xtend Functionalities on Xero Universal Viewer
Technology | Remote Viewing Systems | July 27, 2017
Agfa HealthCare announced it has received U.S. Food and Drug Administration (FDA) 510(k) clearance for the Xero Xtend...
Overlay Init