A Cure for Commoditization

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Quality was on the tips of many tongues last week at the RBMA meeting in Colorado Springs, yet quality continues to be enigmatic. We have the CMS measures—PQRS, Hospital Compare, Physician Compare, MOC, and PQI, ACR accreditation for outpatient imaging centers—and the private payor measures, most notoriously represented by prior authorization. What radiology considers quality is less defined and, to date, falls into three categories: subspecialization, critical results communication, and accuracy. On the sold-out RBMA exhibit floor, eight teleradiology companies offered subspecialty reads, and one information technology company—eRad—offered a web-based, cloud-hosted distributed reading list that facilitates subspecialty reading across disparate sites. As measures are further defined, look for the vendor community to step up to develop tools that help practices meet the challenge. McKesson Revenue Management Systems, for instance, has developed a web-based suite of tools wrapped into its enterprise Qualitative Intelligence Communication System—including the PeerVue product—that enables radiology providers to manage and communicate critical results, physician peer review, and ER communication across multiple sites and multiple PACS. The time has never been better to get proactive about quality. CMS now has the authority to designate as official quality programs developed by specialty societies, according to Judy Burleson, director, metrics, the American College of Radiology. “In the American Taxpayer Relief Act of 2012, one element is that CMS is authorized to look at other quality programs, such as those developed by regional collaborations, MOC, and specialty societies,” she reports. CMS issued an RFI seeking input on quality programs that could be adopted for PQRS measures, value-based purchasing, and MU quality measures, to which the ACR responded. Being able to define, measure, and report quality also will become an increasingly important competitive strategy, as evidenced by the experience of Stamford Hospital, recounted by Sharon Kiely, MD, chief medical officer of Stamford Hospital, in a session titled “Nationwide Radiology—Coming to Your City Soon,” moderated by CliftonLarsonAllen’s Joe White. After putting out an RFP and narrowing the field to three—two national teleradiology companies and one regional radiology private practice—Stamford chose a national teleradiology company to provide service because the regional practice would not offer a guaranteed turnaround time.