Can Health Informatics Reduce Health Care Costs?

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The answer to that question may appear obvious to imaging informatics professionals, but a study released earlier this year by the Government Accountability Office (GAO) disputed the ability of health informatics to reduce health care cost. Now, all of us in radiology have seen the ability of informatics to reduce imaging costs within the radiology practice, the radiology department, and the enterprise. In radiology, the deployment of health information systems has resulted in an unprecedented increase in radiologist productivity during the past 10 years. We've even seen the ability of decision-support systems to reduce the cost of imaging in the greater metropolitan Minneapolis market, in some practices by as much as 10%.

Back in May 2008, when the report was issued, the Wall Street Journal suggested that the study had put an end to the hope that the government would make a significant investment in health care IT. This isn't necessarily a bad thing. The more we chase a one-size-fits-all IT solution for health care, the more we pitch money into a black hole. Besides, we've already bought the banks.

The best places to see how a diverse set of information systems, thoughtfully applied, can result in reduced costs are the heterogeneous environment of the radiology practice and the imaging data centers of well-run health systems.

In the past year, in this e-journal and in the RadInformatics column in ImagingBiz.com, we have reported on the IT strategies of a number of radiology practices. In many cases, the initiatives resulted in either reduced costs or increased productivity. At Austin Radiological Association, Todd Thomas, CIO, and Laura Casey, business office director, used a mix of off-the-shelf hardware, an HL7 interface engine, and custom code to produce a paperless billing system that reduced FTE costs by 75%.

Ron Hosenfeld, CIO, Riverside Radiology, Columbus, Ohio, told us how he built a distributed reading solution using his PACS and an HL7 interface engine propelled by a WAN accelerator to provide 22 sites (spread out over a 160-mile area) with subspecialty interpretations.

Jesse Salen of Online Radiology Medical Group, Riverside, Calif, devised a single sign-on solution, through a PACS/RIS upgrade, to enable radiologists to sign on from home to read studies for teleradiology clients.

Jack M. Jones, CIO for Radia, Everett, Wash, and Jeffrey Robinson, MD, teleRadia medical director, hired a software engineer to build a new front end for two PACS using optical character recognition software and several new databases. Designed to meet even the needs of teleRadia's least sophisticated teleradiology clients, the new system is estimated to improve radiologist productivity by 5% to 10%.

Scott Starkey, director of digital imaging, OhioHealth Information Services, Columbus, Ohio, implemented a virtual server environment, reducing power and physical space requirements, cutting the cost of server hardware by a factor of 15, and creating a reliable business-continuity strategy. Next up: Extending access to PACS for referrers by virtualizing the desktop.

Reportedly, the GAO research was done in response to a Rand report that detailed the potential cost savings that would accrue from a substantial investment in IT. If incentives are aligned and if talented, innovative informatics professionals are charged with the mission, health care IT can have as significant a cost impact on the US health care system as it has had on radiology.

GAO report
Rand report