Going the distance for continuous improvement and excellence in radiology

Triathletes running to bicycles on beach

If you want to understand where radiology and radiology workflows are heading, just listen to your colleagues, friends or family members talk about fitness routines. Gone are the days when getting fit was mainly about pumping iron, working the weight machine circuit or getting on a cardio machine. People still do those things, of course, but now in the context of functional training for an activity, sport or event. They have broader goals beyond losing weight or building muscle. They are working toward practical results and overall improvement, and they aren’t confined to workouts and motions defined by the equipment.

I’m currently doing that myself while training for my second triathlon later this year. My first one taught me a couple of important things. First, I discovered that my performance had a lot of room for improvement. Second, I needed to adapt my training to target specific improvements to help me attain my overall goals. It’s hard work, to put it mildly, because my push to do better must be continuous.

The radiology workflow version of functional training is a shift from the traditional models of the RIS- or PACS-driven workflow. Those are roughly the equivalent of the old-school gym debates about the relative advantages of free weights vs. machines. The RIS (and now EMR) models argue that they provide more clinical context and data. The PACS position focuses on the use and capabilities of the viewer and the radiologist’s ability to derive maximum insight.

Those models grew from the requirements of the healthcare system and the imaging technologies at the time. But the economics, technologies and practices of the healthcare system have changed. Health systems are emphasizing operations, workflows and efficiencies. Revenue doesn’t come from utilization, but instead, from outcomes. An added pressure is that radiologists have found themselves tied more to legacy RIS or PACS systems and further removed from patient care.

In comparison, Nuance Healthcare’s radiology equivalent of functional fitness training places radiologists in broad control of workflow to deliver results producing the diagnostic report, communicating critical findings, managing peer review workflows, identifying, and increasing operational efficiencies, and orchestrating workflow across specialists and subspecialists. This includes optimizing resource utilization and improving turnaround times. The results-driven model unties the workflow from the PACS and the RIS and lets users build a process that supports the desired results.

A results-driven workflow also facilitates and improves patient care. As with functional training it focuses on practical everyday benefits. For example, PowerScribe 360 Workflow Orchestration ensures that the right exams are read by the right specialist at the right time, and that various levels of priorities are optimally managed. It recognizes that not all STAT exams are the same, and that workflow seamlessly continues when interruptions happen. It’s responsive because it’s designed functionally for the real-life radiology workflow.

So instead of free weights vs. machine, treadmill vs. roadwork in fitness, the shift in thinking about radiology workflow from RIS- or PACS-driven to results-driven workflow is about the desired outcomes for the hospital, the patient and the radiologists. It’s about training for continuous improvement and overall excellence.

As for my triathlon training, suffice it to say that I won’t have any sponsors bidding for my product endorsements. However, I will consider continuing improvements and achieving personal goals my very own version of excellence.


Karen Holzberger

About Karen Holzberger

Karen Holzberger is the senior vice president and general manager of Nuance’s Healthcare’s diagnostic solutions business. Karen joined Nuance in 2014 with more than 15 years of experience in the Healthcare industry. Prior to Nuance, she was the vice president and general manager of Global Radiology Workflow at GE Healthcare where she managed service, implementation, product management and development for mission critical healthcare IT software. Karen attended Stevens Institute of Technology where she earned a B.S in Mechanical Engineering.