Investing in Radiology IT: A Three-pronged Strategy
Joe DegatiThis article is the first in a four-part series. Imaging, like the rest of medicine, is experiencing an unprecedented proliferation of IT products. In the wake of IT-friendly legislation such as the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Patient Protection and Affordable Care Act, providers are experiencing more impetus than ever before to invest in the IT necessary to connect them to other providers, to enable them to care for more patients with fewer reimbursement dollars, and to pave the way for their participation in future care-delivery models. On February 23, 2012, radiology received an additional boon in the form of the CMS proposed rule for stage 2 of the meaningful use of electronic health records (EHRs), which includes a menu-set measure focusing on image accessibility via EHR. Joe Degati, CTO for Medical Management Professionals, Inc (MMP), says, “Radiology practices have to get on board with industry-wide changes coming from the DHHS, CMS, the HITECH Act, and so on, but when developing a technology-investment strategy for the next 24 or 36 months, the practice cannot just consider its own needs. It also has to consider the needs of the referring physician—and, most important, the patient.” Practice Needs Leveraging technology to serve these two constituencies represents a fairly new challenge for radiology practices, Degati notes. Historically more sophisticated in IT than some of their peers in the health-care sphere, radiologists, nonetheless, have traditionally focused on improving their own productivity and their practices’ own bottom lines. “Practices really need to focus on what their customers—patients and referring physicians—need from them,” he says. “Practices need to appeal to their customers and understand their key value propositions.” Practices’ needs are evolving as well, however. Degati observes that going forward, practices will need technological solutions that enable them to be agile in serving multiple clients: hospitals, health system, and even accountable-care organizations (ACOs). “In the past, we have heard of inefficiencies where a practice is reading for multiple hospitals and needs multiple workstations in its offices so it can handle work from all these facilities,” Degati says. “That will not be efficient enough for practices, going forward.” He looks to interoperable, cloud-based solutions to change the paradigm for beleaguered practices. “It is all about interoperability,” he says. “It is all about exchanging data in standardized formats.” In addition, Degati notes, practices will need to continue to keep profitability and productivity in mind when evaluating prospective new solutions. “These solutions should be as much about improving profitability as they are about increasing quality and efficiency,” he says. Patient Needs As health IT becomes more mobile, health-care applications for flashy consumer devices such as the iPad are popping up left and right. When contemplating an investment in these applications, however, Degati urges practices to exercise caution and use common sense. “You have to consider strongly which factors are most important to the patient,” he says. “A patient coming into the practice for the first time may be impressed by the use of iPads, but at the end of the day, if they do not make the practice more efficient or improve its quality of care, they will not really mean anything to the patient.” Instead, Degati says, practices should focus on technological solutions that truly improve the patient experience. “I have been to physician practices and have been very impressed by their use of technology—but once I have to sit in a waiting room for two hours, I am not so impressed anymore,” he notes. For example, Degati says, radiology practices can expect to see more and more patients who wish to receive their exam results on their mobile devices—and being able to provide these capabilities effectively will require an increased focus on data security. “The thrill of the technology is that it is progressing so quickly, but we need to be mindful that it is not outrunning our ability to ensure that information is as secure as it needs to be,” he says. Referrer Needs The issue of security also comes into play when meeting referrers’ evolving needs, Degati says. “The one consistent concern of all stakeholders is the protection of information and privacy,” he says. “We see referrers wanting reports on their iPads or their Android devices, and practices may have the capability to send them to those devices—but how can they ensure that the referrers are protecting them? What about the physician who emails the image, but his or her email is unencrypted?” These issues will only intensify as radiology practices try to join ACOs or participate in bundled-payment programs, Degati says. Even practices with robust IT departments might find themselves unprepared to meet evolving security needs. “We are seeing this now with HIPAA 5010,” he says. “What a disruption: Practices understand the reasons behind the regulations, but they have to be tired of the constant disruption, and it is only going to continue as new payment and delivery models come into play. Practices need to consider heavily the security of their information, as well its timeliness and accessibility through mobile solutions.” Degati concludes by noting that with so many IT solutions for practices flooding the market, a well-defined investment strategy is needed. “There are a lot of potential disasters and wastes of money out there. The right strategy will help radiologists protect and grow their businesses while letting them focus on what they do best, which is practicing medicine,” he says. Cat Vasko is editor of and associate editor of Radiology Business Journal.