Medical imaging and consumer-driven healthcare

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While medical imaging specialists today find themselves under increased pressure to demonstrate value, the need to prove value is certainly not new to the medical imaging field.  In fact, the explosion of new imaging technology and resultant value to patient care are the chief reasons why medical imaging grew so rapidly over the past three decades.  Appropriate growth came from clinical deployment of technologies that benefitted patients (e.g., MRI, PET, Spiral CT, breast imaging, cardiac imaging, and interventional procedures).  Inappropriate growth came largely as a result of self-referral legal loopholes and defensive medicine.

The pressure to eliminate unnecessary imaging and control imaging costs has never been greater. This pressure is fundamentally driven by consumers and employers who find healthcare unaffordable. Payers - both private and public - have reacted by progressing the way they financially incentivize providers. Accountable care organizations (ACOs) and employer-based programs that aim to direct employees to lower cost providers are two recent iterations in this evolution. Managed care and imaging benefit managers are other longstanding approaches.
Healthcare payments are evolving and heading in two conflicting directions. On one hand, private and public payers are increasingly basing provider compensation on outcome rather than the number of service events. On the other hand, the U.S. is also in the midst of a rapid rise in consumer out-of-pocket spending for healthcare, estimated to grow to about $450B annually within the next year or so. As a result, consumers themselves are becoming motivated healthcare shoppers.
Another important trend in the imaging healthcare marketplace is the development of cloud-based information and image management technologies. For the past few decades regulatory and technology burdens have driven providers into larger organizations. Now, the new availability of cloud-based information technology may actually favor small entrepreneurs in the ambulatory environment. You don’t have to be big to deploy cloud-based technologies. Smart, small organizations may become more competitive again.  
Here are four key ways medical imaging providers can increase their success:
  1. Connect to consumers via the web to provide both convenience and a higher understanding of medical imaging. Such conveniences and benefits may include:
    • Pre-registration
    • Appointment reminders and confirmations
    • Clinical report and lay letter delivery
    • Secure messaging—including appointment requests
    • Sharing information to/from personal health records (PHRs)
    • Image delivery, forwarding, and storage
    • Online bill pay
    • Transparency of your cash-pay fee schedule
    • Real-time eligibility and co-pay checking
    • Education
    • Patient health risk self-assessment
  1. Help consumers comply with appropriate “preventive” medical imaging procedures, including those specified by entities such as the United Stated Preventive Services Task Force (USPSTF) and in many cases covered by CMS under the Accountable Care Act.
    • Consider screening patients prior to and during visits to increase compliance with appropriate imaging screening procedures such as bone densitometry, mammography, abdominal aortic aneurysm ultrasound screening, breast MRI (in high risk populations), lung cancer CT screening (in high risk populations), and cardiovascular risk assessment. This can not only improve your business, but also improve the preventive health performance of your affiliated healthcare organization.
  1. Connect with referrers via the web, with solutions like Merge’s iConnect® Network Services
    • Leverage industry standards, like Direct Messaging, to receive and view referral information (transfer of care documents) from referring doctors’ EMRs
    • Delivery reports directly to referring doctors’ EMRs
    • Provide scheduling guidance to get to the right test first
    • Share images conveniently, whether performed at your facility or received for comparison or second opinion
  1. Evolve your perspective
    • If you are an imaging physician, allocate some time each day to interacting with referring doctors and patients. In other words, use technology to increase you customer contact, not to shelter you from customers.
    • Be certain that you designate physician leadership. Most importantly, allocate time for your leaders to pay attention to all of this.

Apply these basic ideas, and not only will you increase your own success, but you will improve the success of your affiliated healthcare organization and the health of your community.
Questions? Comments? I’d love to hear from you.
Murray A. Reicher, MD FACR
Chief Medical Officer
Merge Healthcare

Originally posted on: 7/23/2015 9:00:11 AM
Tags: ACOs, consumer

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