Whither the Referrer?

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In tours of the exhibit hall both yesterday and today, I've noticed something interesting about the informatics vendors: their emphasis is no longer on radiologist workflow. Instead, they are focused on leveraging IT to help radiology groups improve their service to two key constituencies: patients and referrers.
Of course, in some sense this is still a conversation about workflow. But rather than adding tweak after tweak to PACS tools, vendors are now asking themselves the same questions that radiologists in practice are struggling with: how can we become more consultative when time is at a premium? How can we better contribute to the patient's care management when we spend so much of our time in the reading room? In a session yesterday afternoon, Dr. Larry Muroff had a simple answer: you can't. The old workflow is outdated and will relegate radiology to a commoditized role, if it hasn't already. What the new workflow will look like remains to be seen, but if vendors' offerings this RSNA are any indication, it will include seamless access to patient data from the EMR, an intuitive approach to critical test results and report delivery functions that emphasize referrer convenience. The PHR is also back, after a fashion, as several vendors are demonstrating patient portals for radiology images and results. These portals make the patient the nexus of image distribution, giving him or her the ability to share images with providers as he or she pleases, often from mobile apps. And speaking of mobile apps, I had to pick my jaw up off the floor after hearing this morning in a session about informatics that 70% of physicians now own iPhones; penetration for iPads is not far behind at 60%. Referring physician apps demonstrated on shiny white Apple products have always made for fine showmanship in the exhibit hall, but that fantasy has become a reality more rapidly than anyone could have anticipated. Vendors are responding by offering their customers a host of new capabilities to extend to referring providers' mobile devices, from zero footprint PACS access to patient scheduling and results notification. It is clear, from these innovations, that the message has finally sunk in that radiology practices will live or die based on service. Quality, as they say, is an expectation; service that is modernized, convenient and increases patient engagement, on the other hand, is a differentiator.