Why Design Matters in Imaging

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It’s design that can make patients choose one imaging provider over another, according to Morris A. Stein, FAIA, FACHA. At the architecture/engineering firm HKS, Inc, Franklin, Tennessee, Stein is a principal. He presented “Designing the Imaging Experience: Understanding Today’s Requirements for Size, Technology, and Environments” on August 11 in Las Vegas, Nevada, at the 2009 annual meeting of AHRA: The Association for Medical Imaging Management.

Good design, Stein says, must be applied not just to imaging technology and the health care environment, but to the entire imaging encounter, as experienced by staff and by patients and their families.

Design as Strategy

Both because of the accelerated pace of technological change in medical imaging and because of the fierce competition for market share that is often based on how well imaging providers are able to keep up with that change, Stein describes today’s radiology market as technologically aggressive. In addition to the need to supply state-of-the-art imaging in order to compete for business, providers are subjected to other forces as dataset sizes increase, as procedure times decrease, and as reimbursement-related pressures grow.

All of these drivers not only influence the design of the imaging facility, but respond to it as well. It is time, Stein says, to approach design as involving far more than the physical space where imaging takes place. Instead, it encompasses the complete imaging experience (both for those who undergo it and for those who provide it). In turn, design affects workflow, staff efficiency, patient throughput, employee recruitment and retention, operating costs, and patient satisfaction.

According to Stein, the final responsibility for helping imaging providers deal with technological change is shared equally among facility owners, equipment manufacturers, designers, and architects. The improvements in the environment and in the workflow passing through it made by each of these parties complement the changes that the others make in response, leading to ongoing progress toward a better overall imaging experience.

While Stein acknowledges that there are fundamental differences between types and levels of imaging technology (and that these differences are both important to the imaging experience and unique in their effects on it), he finds that these differences are becoming less significant than they might once have been in distinguishing one provider from another.

Winning Business

Imaging is the premier area of health care in which design has assumed prominence, Stein says, because of the rigid technical requirements of imaging equipment and because of design’s ability to affect the patient’s experience before and during the procedure. Of course, that experience then influences the patient’s desire to return to the same facility; the recommendations that the patient makes (or declines to make) to colleagues, friends, and family members; and the satisfaction with the imaging provider that the patient expresses to the referring physician on the next medical visit. Satisfied patients influence other patients to request imaging at a particular facility, and dissatisfied patients can cause physicians to stop referring patients to that facility. Patients might not be in a position to judge the technical aspects of imaging, but they will definitely judge the quality of the imaging experience.

A look at the promotional materials and meeting exhibits of any manufacturer of imaging technology will reveal that technical capabilities are only part of the claims made for a product, Stein notes. The effects of design, particularly where they concern efficiency, workflow, and throughput, are also important aspects of the benefits attributed to their products by manufacturers and are being described more prominently.

The reliance of imaging providers on architecture to solve problems is becoming more pronounced as well, Stein says, in response to economic uncertainty. He predicts that this trend will intensify, with imaging facilities increasingly expecting architecture and design to solve problems related to larger procedural volumes, workflow difficulties, hindrances to staff productivity, and even declining reimbursement levels.

By attracting new referrals and retaining existing patients, for example, a facility can use volume increases (if accommodated by good design) to help offset decreased per-exam reimbursement. Poor design, on the