With the possible exception of diffusion-tensor MRI for concussion in athletes, no clinical imaging procedure stands a chance of bumping information technology—with its attendant ripple effects on regulatory compliance and business performance—off radiology’s figurative front page in 2016.
For starters, watch for the continued general blossoming and fine-tuning of medical data normalization, natural language processing, auto-formatting and deep machine learning.
Targeted analytics of big data will guide the implementation of ICD-10 decision-making, and universal formatting will enable everything from identifying internal inconsistencies in reports to flagging omitted language that’s required for reimbursement or PQRS reporting.
|Benjamin W. Strong, MD (ABR, ABIM), Chief Medical Officer, vRad|
Not only will all of these IT advances keep getting better, they’ll also intelligently integrate into radiologists’ normal daily workflows.
At least, that’s what you’ll see if you keep an eye on vRad in 2016.
“Within healthcare, everyone’s biggest challenge has been, and will continue to be, integrating software systems developed outside our industry into a radiology workflow in a practical fashion that has immediate effects—here, now, today,” vRad’s Chief Medical Officer, Benjamin W. Strong, MD, told Medical Imaging Review in a recent review-and-outlook interview.
Strong stresses that the nation’s largest provider of radiology services is pursuing the continued development of the aforementioned technologies “from a very pragmatic standpoint.” He adds: “How does each technology help us serve our clients right now? And how can we use it to help us serve them better in the future?”
|Shannon Werb, Chief Information Officer, vRad|
The digitalization of the profession at MEDNAX affiliate vRad, which employs nearly 400 radiologists, isn’t always about efficiency, adds vRad CIO Shannon Werb. “It’s also about making sure that we create the right environment for patient-facing physicians to provide the best quality care they can,” he says.
As U.S. healthcare continues transitioning from volume-based to value-based reimbursement in 2016 and beyond—most notably with government initiatives dialing up pressure on providers to demonstrate quality and safety—Strong and Werb are of one mind on how to help those patient-facing physicians stay ahead of the curve: Equip vRad’s radiologists with technological tools that all but self-deploy.
“Reducing our turnaround times, improving our patient care and increasing the satisfaction of our clients—across the board, that’s always what we are looking to do,” says Strong. “It’s a case of our rising tide lifting all their boats.”
To give an example of a specific application in action to this effect, Strong points to vRad’s implementation of a patent-pending customized structured report formatting program entitled rScriptor by Scriptor Software. Highly customized for vRad’s unique and patented workflow, each vRad report is created in real-time using line-by-line dictation and follows a consistent template that includes Exam, Technique, Comparison, Findings and Impression. This he describes as “universal” because it’s used across the massive practice, and with big buy-in from the rads, at that.
The custom formatting program “uses natural language processing for the precise identification of phrases,” he says. “Recommendations for a lung nodule, grading of trauma injuries, categorizing osteochondrosis defects—all of those things are built in so as to give real-time warnings to the radiologist (upon dictation).”
“The flexibility is astonishing,” he adds. “We can build in financial or reimbursement requirements, reporting accuracy and thoroughness requirements—really just about anything where we need the radiologist’s constant vigilance and constantly current knowledge of best practices to be applied.”
Strong says implementation of the vRad customized rScriptor formatting program is directly creditable for a major fiscal achievement in 2015: It lowered the practice’s own reimbursement refusals by significant double digits.
Big data is only the beginning
Looking back on the technology-enabled breakthroughs that contributed to vRad’s current market position, Strong and Werb note that the big gains began taking shape in 2013, when the practice recognized that it needed to work with normalized datasets.
“We apply normalization much more broadly now than then,” Werb says. “But we started at