Whitney Palmer

Healthcare. Politics. Family.

Radiology and Pathology: Time to Integrate

Published on the Jan. 12, 2015 DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — For several years, there’s been a push in health care – particularly in pharmaceuticals – toward personalized medicine. By using a patient’s genetics to better target their medications and therapies, the medical industry has achieved improved patient outcomes.

But, what if you could launch individualized care at an earlier stage – at the point of pathological diagnosis? According to radiology and pathology experts at the 2014 Radiological Society of North America annual meeting, this could be the next wave that takes personalized medicine to the next level.

“The idea is to personalize how we treat patients based on their unique characteristics,” said Mitch Schnall, MD, PhD, radiology department chair, University of Pennsylvania. “The idea of developing data that characterizes someone really gets to the heart of what diagnosis is about. It’s crucial to realizing any benefit.”

To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/radiology-and-pathology-time-integrate

January 13, 2015 Posted by | Uncategorized | , , , , , , , , , , , , | Leave a comment

No Such Thing as Big Data in Health Care

Published on the Dec. 3, 2014, DiagnosticImaging.com website

When it comes to big data, health care doesn’t really have any. And, for radiology, that’s a good thing. Small and medium data will work just fine – especially for testing and designing new reimbursement models, according to speakers at this year’s Radiological Society of North America (RSNA) meeting.

Industry experts at this year’s RSNA say the data hospitals and health care systems already have can help providers identify ways to maximize their influence in the design of any future payment models.

“We’re currently in the lowest life form of payment policy. We get paid for events – it’s a transactional delivery system,” said Richard Duszak, MD, vice chair for health policy and practice, department of radiology and imaging sciences, Emory University School of Medicine. “Increasingly, we’re moving to models where we’ll be paid by encounters and engagements.”

The question, he said, is how those models will be designed to ensure radiologists receive appropriate reimbursement for services rendered in a correctly incentivized way. To date, there’s no clear-cut answer, but there are steps radiologists can take – armed with small-to-medium data – to ensure their seat at the decision table.

To read the article in its entirey at its original location: http://www.diagnosticimaging.com/rsna-2014/no-such-thing-big-data-health-care

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , , , | Leave a comment

RSNA Collaborates, Sets to Improve Radiology Reporting

Published on the Dec. 16, 2014, DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — It has been six years since the Radiological Society of North America (RSNA) launched its Reporting Initiative. In that time, radiologists across the country have benefited from the tools it offers, according to the Initiative’s leaders and other industry experts, who revealed its accomplishments to date and discussed what’s yet to come.

“Our goal, in part, was to improve the quality of radiology reports, making it easier for referring physicians, patients, and other radiologists to use and have the information that we can extract from reports,” said Charles Kahn, MD, chair of the RSNA’s Radiology Informatics Committee Structured Reporting Subcommittee. “We wanted to develop a better, more robust system that could go beyond speech and voice recognition and really empower the capture of information as radiology becomes more quantitative.”

Rather than dictating to radiologists and practices exactly how they were to create reports, this initiative was designed to collect a sampling of best practice templates that providers could modify to meet their own needs, he said.

To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/rsna-collaborates-sets-improve-radiology-reporting

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , | Leave a comment

To Avoid Malpractice, Radiologists Must Communicate

Published on the Dec. 22, 2014, DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — With the roll-out of the Affordable Care Act (ACA) still ongoing and the move toward some type of accountable care organization model still underway, it’s unclear how radiology will fare in any medical malpractice lawsuits.

But, industry experts at this year’s Radiological Society of North America meeting all point to one key component of financial survival – communication. Communication with referring physicians, the patient, and each other.

“You have to remember there are three factors to communication – the referring physician, the radiologist, and the patient,” said Leonard Berlin, MD, a radiologist with NorthShore University Health System. “Communication is the link between all three. It’s obviously a real problem when there’s a failure to communicate emergency or acute findings, but it’s significant that there’s a large amount of significant and unexpected findings that don’t get communicated either.”

To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/avoid-malpractice-radiologists-must-communicate

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , , , , , , | Leave a comment

Why Radiologists Should Care About Clinical Decision Support

Published on the Dec. 24, 2014 DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — The buzz about clinical decision support and the need for appropriateness guidelines isn’t new, but implementing and using such tools correctly will soon become even more critical.

According to industry experts at this year’s Radiological Society of North America annual meeting, if your referring physicians don’t master their clinical decision support (CDS) and use it consistently, it’s going to cost the radiologists money.

As of Jan. 1, 2017, said Ramin Khorasani, MD, vice chair of the Brigham & Women’s Hospital radiology department, under the Protecting Access to Medicare Act, radiologists won’t be paid for outpatient, non-emergent services rendered if their claims don’t include a number that proves the referring physician consulted a CDS tool.

But it still isn’t clear how radiology can best teach other providers about diagnostic imaging appropriateness. A recent pilot initiative, the Medicare Imaging Demonstration (MID), showed some improvement in how referring physicians prescribed imaging, but many doctors and surgeons reported dissatisfaction with the CDS software.

To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/why-radiologists-should-care-about-clinical-decision-support

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , | Leave a comment

Mixed Messages About Breast Density As Risk Factor

Published on the Dec. 26, 2014, DiagnosticImaging.com Website

By Whitney L.J. Howell

CHICAGO — As of July 2014, 32 states either had a breast density notification law or were working on legislation. Connecticut passed the first law in 2009, but what has  been the impact to-date on identifying the sneaky cancers that hide?

According to industry experts at this year’s Radiological Society of North America meeting, new cancers are being found, but radiologists have learned something else in the process. Dense breast tissue doesn’t necessarily raise a woman’s risk of breast cancer – instead, it more directly affects the sensitivity of the test she receives.

“The increased rate of breast cancers in dense tissue is largely due to masking – the obstruction of the cancer by the dense tissue,” said Stephen Feig, MD, a radiologist at the University of California-Irvine with an interest in breast screening guidelines and controversies. “Dense breast tissue is much less associated with an actual higher risk of developing the disease than was originally anticipated.”

To read the story in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/mixed-messages-about-breast-density-risk-factor

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , , , , | Leave a comment

Financial Planning For Radiology Residents

Published on the Dec. 30, 2014 DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — It is well known that resident salaries are falling below those of practicing providers. But, if you establish good financial planning habits now, it will be easier to manage your income and prepare for retirement.

During the Resident Forum at this year’s Radiological Society of North America meeting, Greg Wikelius, a financial planner with Chicago’s North Star Resource Group, offered guidance to help radiology residents map out their future financial security.

“The most critical time in your financial life is when you transition from training as a radiology resident into practice,” he said. “The reason is you’re not yet used to spending the higher income. This is the easiest time to get on track – if you make the necessary cuts in your income now, you’ll never miss what you’re cutting out. It’ll be much harder to do 10 years from now if you’re accustomed to spending the money.”

To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/financial-planning-radiology-residents

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , , , , | Leave a comment

What Interoperability Means For Radiology

Published on the Dec. 31, 2014 DiagnosticImaging.com website

By Whitney L.J. Howell

CHICAGO — When it comes to health care information technology (HIT), the latest buzzword is interoperability.

Up to this point, the vast majority of HIT implementation has centered on merely introducing hospitals, ambulatory clinics, and private practices to the tools that will drive health care delivery in the future. But, according to industry experts at this year’s Radiological Society of North America annual meeting, the federal government now says it’s time for everyone to start talking to each other.

“From the frontload, our conversations were about incentives – more incentives drove HIT adoptions,” said Doug Fridsma, MD, PhD, president and chief executive officer of the American Medical Informatics Association. “Now, the last thing, and the most important point is interoperability.”

To read the story in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/what-interoperability-means-radiology

January 1, 2015 Posted by | Healthcare | , , , , , , , , , , , , , , , , | Leave a comment

Radiology in 2013: The Year of Imaging Software

Published on the Jan. 3, 2013 Diagnostic Imaging website

By Whitney L.J. Howell

For radiologists and radiology vendors, the past 12 months have centered on health care reform – would the U.S. Supreme Court uphold the law, and if it did, what would it all mean? With the court’s decision, at least part of that question has been answered. Now, the industry has turned its focus to what can be done in the next year to make practice more efficient and improve how its providers interact with other specialties.

One of the biggest strategies for accomplishing this goal will be the implementation and use of new software offerings, experts say. The increasing use of more complex information in radiology practice has necessitated intelligent systems to more effectively capture and analyze data. Whether the new products impact work flow or patient care, new software developments will play an integral role in how you obtain, analyze, and share images in the future.

According to Eliot Siegel, MD, diagnostic radiology and nuclear medicine professor at the University of Maryland, the bulk of new software capabilities will target enhanced communication, taking how providers share information to the next level.

“So much effort has been put in during the last 20 years to actually get us to the point of being digital and having images available anytime, anywhere and being more efficient in image interpretation,” said Siegel, also the associate vice chairman of informatics. “But relatively little has been done about communicating radiology findings and information that’s important about the patient and making sure we receive return communication that our recommendations have been acted on.”

Within the next year, he predicted, radiology software will meet provider needs by not only recording when studies are completed, reported, and shared with referring physicians, but also by providing feedback on whether referring physicians acted on any radiology recommendations.

Main Provider Desires

A common provider complaint is the difficulty frequently associated with transferring images from one facility to another. In many instances, CDs are lost or referring physicians can’t download the images. Sharing studies between health care systems is also a particular challenge, Siegel said.

“It would be good to see hospitals and clinics having more universal use of images,” he said. “We should be able to transfer images directly and digitally, like sending an email. Only it would be in a safe, secure way from one facility to another.”

The Image Share Network, launched by the Radiological Society of North America (RSNA), is already moving the industry in this direction. Tested at five pilot sites nationwide, this initiative gives patients access to their diagnostic images via a patient health account, enabling them to transfer images to their physician much like they would in their email accounts.

Siegel also predicted the rise of software that can produce better analytics for radiology, as well as enhance natural language processing for radiology reports. Ultimately, he said, an effective system would summarize pertinent information and allow providers to either agree or disagree with the computer’s interpretation of the data. Such a system would offer improved text and structure capabilities.

What’s Coming in Communications Software

One of the most active areas in communications software development is work around speech recognition and natural language processing. Several companies are working to make these tools smarter, Siegel said.

For example, M*Modal and Nuance are developing software that will be able to understand and discern meaning from, and potentially act upon, information included in reports. Montage is also creating software that can mine current and previous radiology reports for specific words, such as pneumothorax, and correlate them with pathology reports.

“I’m really excited about this next generation of intelligent systems that generates reports and makes sure they’ve been read and acknowledged,” he said. “Computers can be useful tools to understand and extract information from the report, act on it, and allow for follow-ups.”

Additionally, many vendors are tackling improved image sharing software, using RSNA’s Image Share as a model. The most important advancement here is that these products will likely be standards-based rather than proprietary. Having a universal solution will allow health care facilities of all types — both in the same and different systems — to share all types of diagnostic imaging data associated with individual places.

Although the solution isn’t yet standards-based, information technology software developer mPlexus introduced its latest product — DICOM RadiX — at this year’s RSNA annual meeting. This automated software shares images and retrieves them from imaging archives instantly. When integrated with other mPlexus products, RadiX can transfer images between facilities, even those in separate institutions.

To read the remainder of the article in its original location: http://www.diagnosticimaging.com/informatics-pacs/content/article/113619/2121622

February 26, 2013 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Radiology: What’s Coming in 2012

Published on the Feb. 16, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

Throughout 2011, most chatter in radiology centered around how healthcare reform would change the industry or how practitioners should manage and use newer modalities. In a look ahead at the next 12 months, many industry luminaries anticipate the same concerns will linger on the horizon even as new ones appear.

Some of the upcoming challenges touch the individual radiologist’s pocketbook; others affect practice. Regardless of the specifics, radiologists will do well to revamp how they view themselves as part of the healthcare system, said James Thrall, MD, Massachusetts General Hospital (MGH) radiologist-in-chief and former American College of Radiology president.

Financial Implications

Radiology’s biggest concern for 2012 is a holdover from last year — bundled payments and reduced reimbursement. Under the proposed accountable care model, radiology reimbursements would be wrapped up in a lump-sum amount that includes facility, physician, and technical payments.

It’s the ambiguity of these packaged payment’s impact that make them the industry’s greatest challenge this year, said, Leonard Berlin, MD, former chair of the professionalism committee with the Radiological Society of North America (RSNA).

Leonard Berlin, MD, former chair of the professionalism committee for the Radiological Society of North America

“There’s no question that there’s been a definite move to decrease reimbursement for radiology at the Centers for Medicare and Medicaid Services,” Berlin said. “All the projections for radiology reimbursement have it falling, meaning that practitioners, for 2012 and beyond, will need to find a way to maintain and manage a workload that is sometimes heavier for less money.”

The ACR is also concerned about reduced payments. Currently, the organization’s No. 1 priority is working with Congress to extend the temporary fix to Medicare’s sustainable growth rate, the formula used to control healthcare spending. The stop-gap measure, enacted in December 2011, averted a 27 percent physician payment reduction, and the ACR would like to extend the fix permanently.

“We’re also watching carefully to see if we can stop the Centers for Medicare and Medicaid Services from making any multiple procedure payment reductions,” said Cindy Moran, ACR’s government relations assistant executive director, referring to cuts in payment when two or more codes are performed to the same patient by the same physician during a single session. “But we are also assuming, with this being an election year, that we might be faced with a lame duck Congress.”

Changes could also be coming to codes that routinely appear together, said Maurine Spillman-Dennis, ACR’s senior director of health policy. CMS is analyzing whether procedure codes that are often linked 50 percent, 75 percent, and 90 percent of the time can be bundled, reducing overall reimbursement for those services.

“We are involved in an evolution toward a new payment model. The bottom line is that healthcare is turning away from the fee-for-service system and moving toward capitated services,” Spillman-Dennis said. “It will be a challenge for radiology to fight under this new care delivery model and make sure its practitioners are paid for services provided.”

To read the remainder of the article: http://www.diagnosticimaging.com/practice-management/content/article/113619/2033254

February 16, 2012 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment


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