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Imaging informatics accelerates change-agent role in ACA transition

by John W. Mitchell, Senior Correspondent | April 24, 2015
From the April 2015 issue of HealthCare Business News magazine


Dr. David Hirschorn, a radiologist based at Staten Island University Hospital, agrees with Dennison’s assessment and says there are definite improvements for the radiologist in the ongoing evolution of informatics.

“For 100 years, the radiologist didn’t have a patient’s medical record. A lot of the time, we didn’t even know what we were looking for on an image. Now, because our
radiology PACS system talks to the EMR, I can pull up the patient record, make notes to the ER or referring doctor – I can even see comorbid diseases and what meds the patient is on,” he says. Hirschorn says that while younger radiologists he works with can’t image without having the patient record, the huge improvements in the way the radiology PACS trades information back and forth with the EMR is sometimes a challenge for older radiologists.

“Radiologists got acclimated to not having the patient record and we set up our work around that premise. I have to remind some of my colleagues that, hey, we can look up that information now. It used to be that 95 percent of our calls to the referring doctors were to confirm some detail about the patient we were pretty sure about,” says Hirschorn. “Now, we call a lot less, but 95 percent of our calls to the referring doctor are meaningful. This reduces everyone’s frustration level.”

The evolution of Imaging 3.0
“We had 1.0 for 80 years looking at films on light boxes,” says Dr. Keith Dreyer, vice chairman of radiology at Massachusetts General Hospital and chairman of the recently formed Informatics Commission at the American College of Radiology (ACR). “Then we became extremely efficient within the radiology department with 2.0, when we started using PACS. But now, we are at what we at the ACR [refer to as] Radiology 3.0. Radiologists have to reach outside our department to the referring doctor and patient in a more meaningful way, beyond just having access to the images.”

Dreyer says the advent of such metrics as Meaningful Use (required , to get government financial offsets for EMR costs) and Value- Based Purchasing (new metrics to compensate hospitals and physicians for outcomes rather than volume), gives rise to technology and applications to keep imaging in a leadership role as the Affordable Care Act rolls out.

Human behavior aside, much of the advancement in informatics is making the interface between many technologies and applications better, or in IT slang, “play nicer together.” There is no moment more poignant in a hospital administrator’s career than when they realize that they just spent hundreds of thousands of dollars for new computers or software that make the rest of their systems obsolete.

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