Patient-centered care requires education, access, and involvement to ensure patients and families have what they need to make informed decisions. In radiology, this means connecting radiologists more closely to patients and to other caregivers along the patient’s care path to provide quality care and demonstrate it through outcomes.
Here are the top 5 action items for radiologists to get ahead of shifting forces in healthcare:
Demonstrate value not volume
At Massachusetts General Hospital (MGH), radiologists generate more than 2,000 reports a day, and along with those come 10,000 up to 100,000s of images. Will doing more tests drive more patients to the hospital? The goal is not to be the most efficient in imaging, but rather, the most valuable. The value radiologists bring starts with a more reliable, consistent and quality-focused radiology report that connects to better outcomes. Today there can be too much variability between radiologists and reports – and more importantly- recommendations in those reports that tell primary care physicians what to do next with the patient. Top performers will be found from clinical documentation and reported results.
“I teach radiology residents in the ER that the radiologist’s reports are the most valuable and imperative tool they have in caring for the patient, and they should wield that tool as carefully as a surgeon would yield a scalpel,” cites Dr. Alkasab. “One of the ongoing challenges is making those reports more precise in caring for the patient.”
Do the right thing and prove it
Medicine as a whole is becoming more data driven and evidence-based medicine (EBM) has taken hold. Radiologists need to take part in that change. Recommended care paths and industry standards, including those from the ACR, help radiologists deliver high-quality care. It’s important to adhere to these recommended best practices and pass along that information to the next caregivers, such as incidental findings that are unexpectedly seen on images. Knowing what to do and when is critical, and demonstrating that a radiologist did the right thing is increasingly becoming important to prove when reputations and reimbursement are at risk. Technology can help overcome this barrier to make compliance, reporting, and follow-up easier for radiologists and other caregivers involved in the patient’s care.
Shift from detect and diagnose to action
The traditional role of radiologists is shifting from detect and diagnose to aggregator and interpreter to make raw data actionable. This means taking complex, clinically-relevant data coming from a large number of different sources, adding their own specific insights, and packaging this data into information and recommendations that are easy for others to access and consume — from both a physician’s and patient’s perspective. Today this is a barrier because critical information may be buried in text reports or missing, making patient recommendations unclear or records incomplete. In fact, a recent study found that nearly one-third of radiology reports that called for further clinical action were ignored. The question is why.
Connect radiology directly to patient care
With patient portals and Open Notes, there are more eyes on patient charts than ever before, and this will only continue. It’s not unusual for people to pull up an X-ray of their slipped disk on a smartphone or download them using cloud-based medical image sharing. Radiologists have an important role in communicating patients’ complete needs in an easy-to-understand way to help others overcome the challenges patients face. This is an important element in the continuity of care. When you introduce rewards and penalties for falling short on care, the impact on physicians is clear. Radiologists need to be able to show the value in this critical step of the patient care process to help people get the answers they need.
Embrace machine learning
Tools and technologies that help radiologists in the quest for evidence and quality outcomes while supporting efficiency gains can relieve some of the pressure on radiologists. Nuance is doing some of that today with Clinical Guidance built into the radiologist’s workflow and reports. As a whole, more machine learning is on the horizon for healthcare. As noted radiologist, Dr. Nick Bryan, shares in this recent article on Machine Learning (ML) in the radiology practice of tomorrow, “Radiologists read at least 20% more cases per day than they did 10 years ago and view twice as many images. In terms of human visual psychometrics, we are operating at near capacity. Further gains in clinical efficiency will require new technologies such as ML.”
Radiology as a whole is shifting its focus from the end product — reports or images — to taking a more active role in patient-centric care, which requires deciphering complex data and making it meaningful and understood by others involved in the patient’s care pathway. I look forward to continuing to work with physician leaders like those at MGH, ACR, and other organizations to advance the free flow of information and technology innovations to support improved patient care.
On a personal level, I am committed to driving towards a higher level of awareness, detection, and prevention of heart disease in the spirit of my wife, Shalini Maripuri, who died suddenly from undetected heart disease at age 49. Through my involvement with the Shalini Maripuri Foundation and the New Hampshire American Heart Association, I am committed to supporting efforts that have a real impact on people’s lives.