"/>

Too Big to Understand

by Curtis Kauffman-Pickelle

I just finished reading the new book about last year’s financial near meltdown, Too Big to Fail (Viking, 2009), by Andrew Ross Sorkin. The book’s several hundred pages of behind-the-scenes narrative leading up to and immediately following the collapse of Lehman Brothers in September 2008 were instructive on several levels for those of us trying to sort out the complexities of health reform.

Underscored by images of some of the most prominent people in the country’s financial sector literally getting sick into their office wastebaskets, mostly due to anxiety and panic, as they worked around the clock to avert a total collapse of the financial infrastructure, the book’s lessons are replete with examples of lapses in common sense, communication, sound judgment, and (most surprising) skill.

It is the skill piece that most disturbed me when I considered the amount of trust that we, as citizens, place in those who control the levers of power in our various institutions—business, finance, government, academia, and the military. It is safe to say that the skills within today’s military have soared to mountaintop levels. Likewise, business in the United States is the engine of innovation that continues to drive our fundamental economy. I am no expert on academia, but I am frequently amazed by the number of world-class scientific luminaries who are part of our universities.

Click here for more "/>

Leveraging RVU Data to Improve Productivity

by Elaine Sanchez

Friendly competition has developed among the five radiologists of Capital Imaging Associates, Albany, New York, to the benefit of referrers (and, potentially, to patient care). Six months ago, the group implemented an RVU-based system for productivity tracking, which has allowed the physicians to gain awareness of their individual caseloads and how they stack up against those of their colleagues. The ultimate goal is to improve efficiency and maintain the group’s current position as the radiology practice with the fastest turnaround time in its county.

Michael Gabor, MD, MBA, managing partner of the group and chair of the medical imaging department at Albany Memorial Hospital, explains, “At the margin, I’ve been pushing myself. Instead of any animosity, it’s been more that if I have someone breathing on my heels, I’m going to push myself more. It’s a friendly competition, and I think that’s a healthy thing.”

Click here for more "/>

Toward True Globalization: The Air Force and PACS

by Cat Vasko

Sharing images across any health care enterprise represents a challenge, but doing so across the Pacific Rim was the dilemma faced in 2003 by the US Air Force. Taking up this challenge were Lt Col Grant Tibbetts, MD, now radiology consultant to the surgeon general, and Tom Lewis, the director of the Air Force PACS Office. “The largest hospital in the area was at Elmendorf Air Force Base in Alaska,” Lewis recalls, “so at the time, we had to fly radiologists from there to Japan or Korea when they were needed. Solo radiologists within the Western Pacific needed support when they went on vacation or were out of pocket for various other reasons. That’s what led us into trying to get a PACS solution that would allow a global enterprise view and sharing of the workload.”

At that time, the Air Force had implemented PACS at numerous sites around the country, some of which were set up to communicate with smaller sites using a hub-and-spoke approach designed to create efficiencies in staffing. In the Pacific, out of nine imaging sites, there were radiologists at four, with strategic realities often leading to staff reduction at smaller sites. During radiologist absences, these were each supported by the only site that had more than one radiologist: Elmendorf Air Force Base.

Click here for more "/>

Automating Management of Critical Results

by Cat Vasko

When Jane Wheatley, CEO of Taylor Regional Hospital, Campbellsville, Kentucky, needed to make a decision regarding her facility’s handling of radiology services, she had two imperatives in mind: cost and quality. After the hospital’s radiology group disbanded in the early 2000s, the 90-bed acute care center contracted with an outside radiology group “under a financial arrangement that was not good for our hospital,” Wheatley says. “The quality was good, but the economics of it were not good at all.”

Around a year ago, Wheatley solved the issue by contracting with Franklin & Seidelmann Subspecialty Teleradiology, Beachwood, Ohio, for all radiology services. As a regional hub covering six counties, located 80 miles or so from the nearest large city (Louisville), Taylor Regional Hospital needed 24/7 coverage; Franklin & Seidelmann supplied one full-time radiologist who works on-site Monday through Friday, performs interventional procedures, and provides nighttime and weekend readings remotely.

“For hospitals like ours that are more remote, it’s just a wonderful thing to be able to have radiology services 24/7,” Wheatley says. “Now, we have specialists in place, and we can go to them when we need them.”

Click here for more "/>

All Eyes on Accreditation

by Cat Vasko

In July 2008, Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA), which, among other provisions, mandated that all outpatient providers of advanced diagnostic imaging services be accredited by a CMS-designated body by January 1, 2012, in order to receive Medicare reimbursement for the technical component of an exam. Advanced diagnostic imaging services are defined as MRI, CT, nuclear medicine, and PET; CMS will select its accrediting organization or organizations by January 1, 2010.

With the deadline looming, all eyes are on two of the more obvious choices for accrediting bodies: the ACR® and the Joint Commission (formerly known as JCAHO). In an October presentation to attendees at the fall meeting of the RBMA in Phoenix, Arizona, Leonard Lucey, JD, legal counsel for the ACR, noted that both the ACR and the Joint Commission are mentioned specifically in MIPPA as potential accrediting organizations, and both have applied for the designation.

Click here for more "/>

Window on 2010: Impact of Imaging-Specific Health Care Reforms

by Cheryl Proval

Since the dawn of the DRA at the close of 2005, health care observers have predicted a follow-on DRA II. It appears that this prediction will come to pass shortly after the clock strikes midnight on December 31.

In a carefully considered presentation at the Gleacher Center in Chicago on December 2, Shay Pratt, managing director, The Advisory Board, Washington DC, laid out for members the potential impact of the reforms contained in the 2010 Medicare Physician Fee Schedule final rule as well as imaging-specific measures contained in competing health reform bills, both on imaging reimbursement and the freestanding market at large.

“With reform discussions, there is so much going on with imaging in particular that it is a good question to ask: What will happen to future demand and profitability with the current proposals on the table?”

—Shay Pratt, managing director The Advisory Board, Washington, DC

Click here for more "/>

Jeff Bauer, PhD, on Transforming Health Care

by Steve Smith

Health care futurist and consultant Jeff Bauer, PhD, coauthor of the book Paradox and Imperatives in Health Care: How Efficiency, Effectiveness, and E-Transformation Can Conquer Waste and Optimize Quality (Productivity Press, 2007), has raised eyebrows by suggesting that meaningful health care reform faces tough odds on Capitol Hill. He spoke with ImagingBiz.com about his belief that reform has to happen from the grassroots up, highlighting strategies for transforming health care from the provider’s perspective.

ImagingBiz:  Recent research indicates that the United States lags behind many Western countries in terms of widespread, interconnected health IT. What should be done to overcome this lack of interoperability?

Bauer: There are lots of systems in this country that do a wonderful job of interoperability. Mayo has done it, Kaiser has done it. It’s not that interoperability can’t be done; it can be done very well. The problem isn’t interoperability and technology. I’ve got consultants that can go out and do it for you next week. The problem is that we’ve got too many people waiting around for the government to solve it, or believing in the idea that there will be this regional cooperation.

Click here for more "/>

Catching Up With the Future: The Radiology of Tomorrow

by George Wiley

The future is here—it just hasn’t made it to radiology yet. A restless pioneer spirit continues to drive radiology into the future, even if that future is lagging well behind advances achieved by Internet commerce companies. “This is not novel; this is how IT works in every other vertical setting except medicine,” Paul Chang, MD, FSIIM, explains. “We’re 10 years behind the rest of the world. We are arrogant and ignorant—it’s OK to be one, but it’s bad to be both.”

Chang is talking about service-oriented architecture (SOA), a way of creating customized applications by incorporating software in existing vendor systems and linking them to achieve specific purposes. With SOA, he says, the radiologist of the future will be able to access information from various sites so that it all comes together on the workstation. “The big future now is interoperability,” Chang says. “We’ve got the PACS, the RIS, and the electronic medical record (EMR), but they’re all little islands. I don’t want that. I want the best parts of all of them, in an experience optimized for me.”

Click here for more "/>

Asset Management for Imaging Reduces Waste

by Rich Smith

Scarce capital, these days, poses a serious threat to imaging enterprises hoping to see even modest growth. Blame the economy if you will, but there are any number of other contributing factors, including the rapid commoditization of equipment maintenance, punishing tax rates, investment-portfolio losses, and the hold that regulations and legal mandates can place on opportunity.

Given all that, where is an imaging center or radiology department to turn for funding? Look inward, then purge waste, Simon Walls, managing principal of GE Health care’s Asset Management Solutions unit, suggests. “The starting point is your existing base of clinical equipment assets because, in all likelihood, they’re not being optimally utilized, managed, and maintained,” he says. “That means waste is occurring. Reduce the waste and there should be freed-up funds sufficient to support not only day-to-day operations, but also strategic growth initiatives.”

Walls contends that few imaging providers ever stop to consider strategically how their imaging assets help or hurt the bottom line. “Unfortunately, taking health care as a whole, the failure to make this link is each year resulting in billions of dollars of wasted potential capital,” he estimates.

Click here for more

• Archives
• About Us
• Mission Statement
• Staff
• Testimonials
• Affiliates
• Contact Us