Radiology's Changing Role in Healthcare

CHICAGO - Radiology's role in healthcare is changing as healthcare reform continues to roll out, and radiologists will need to alter how they practice to maintain relevance, said an industry expert during RSNA 2013 this month.

"We currently operate in a fee-for-service system that incentivizes volume. We are extremely economically self-interested," said James V. Rawson, MD, radiology chair at Georgia Regents Health System. "But, we must begin to incentivize the work we can't code for - serving on national and hospital committees, taking on leadership roles, becoming involved in medical societies."

It's imperative, he said, to push radiology to the forefront of everyone's radar screen. Providers must show hospital administrators and referring physicians that radiologists can do more than only read a stack of imaging studies. They can play pivotal roles in facility operations and policymaking, as well.

At the same time, Rawson said, practitioners need to link their efforts to positive results for patients.

"You must think about your actions and how they impact particular patients," he said. "Think about the turnaround time you're directly responsible for. Do you take more responsibility from the point of time when the study was completed to when you look at it or from the time it was ordered to the final report sent to the mailbox of the referring physician?"

Claiming greater responsibility can have a clinical impact. For example, Rawson said, there are two clinical areas where radiologist participation has made a significant difference. Using imaging during operation procedures can ensure no foreign bodies, such as sponges or metal clips, are left behind in a patient's body. Removing these items can cost a hospital approximately $160,000 per instance in non-recoupable expenses.

Imaging can also be used to reduce blood stream infections due to improperly placed catheters, he said. Hospitals report nearly 80,000 infections annually that can drive the cost of care up 45 percent. Thirty percent of which are fatal, but image-guided standardized practices have reduced incidence levels to zero in many facilities.

Hospital data also shows that, for many patients, cross-sectional imaging completed on the first day of an inpatient stay can reduce admissions overall from an average of nine days to 8.6 days. The result, Rawson said, is a few hundred dollars per patient admission for the shorter stays - money saved that adds up over time.

There are, he said, a multitude of ways radiologists can positively impact care delivery. Discovering what they are simply requires conversation.

"There are a lot of opportunities to work with hospitals to find areas of common incentives," he said. "Hopefully, they all revolve around common care for the patient."