One-hundred years of RSNA. Complete.
This year's centennial celebration of radiological imaging again attracted the brightest minds in medical imaging from around the world. It showcased the latest advances and highlighted our profession's strengths. The meeting was a hit, with a sense of optimism permeating the canyon-like convention center.
But now, the meeting is over.
We're all back at home. Back to the grind. Interfacing with antiquated electronic medical records in a bewildering, broken healthcare system. We're still pleading with providers to avoid unindicated imaging studies with dwindling pre-test probabilities--and then reluctantly caving when our endurance is depleted. The expectations of our referring physician colleagues remain unfulfilled--and our patients still don't grasp what the role of a radiologist is. Reality is not altered by a meeting, sadly. Not yet, anyway.
The ephemeral flicker of forward-thinking optimism spawned by professional gatherings is real, though. And now, our challenge is to sustain and gain that momentum.
I wrote before the meeting about how we should observe how buyers spent money at #RSNA14. I challenged us all to focus on quality and value--to truly delineate what constitutes such vagaries and how best to measure them. I hoped that analytics platforms, decision support tools, and peer-review reform would be highlighted, and that our obsessions with technological advances would be temporarily dulled.
The top innovations at RSNA, according to Chicago Inno, cited only one analytics/value based vendor (Montage Healthcare Solutions). The other top innovations, according to the source, included 3-D printers, new ultrasound elastography software, 3-D C-arm imaging and early detection of Alzheimer's biomarkers via MRI. These other innovations are amazing, don't get me wrong. I am definitely not smart enough to think of, or create such products/solutions. And we certainly have to continue to technologically innovate for our profession to succeed.
But in my practice, I don't need 3-D printers or ultra-high-resolution, cellular-level ultrasound imaging. (Maybe I will someday.) Rather, I need tools that help me measure real costs of episodes of care. I need solutions that demonstrate how our performance relates to others. I need to be able to determine how consistently we are doing things well. And I need solutions that allow me to begin measuring and tracking patient outcomes as they relate to encounters with imaging and image-guided interventions.
Fortunately, these issues garnered more attention at #RSNA14 than any meeting in recent memory. Presentations from the Neiman Health Policy Institute revealed how targeting the 5.3 percent of DRGs that account for more than 50 percent of hospitalizations may be the smartest approach to initiating bundled payment programs. Leaders in radiology quality and safety, such as David Larson, highlighted that establishing a culture of quality is a long process that requires patience, collaboration and a willingness to start with small projects.
In addition, multiple presentations from young, bright radiologists highlighted how using data from the NCI's Surveillance, Epidemiology, and End Results (SEER) program can delineate actual outcomes of patients receiving various forms of imaging tests and/or interventions.
The future is bright. But we, as radiologists, have to accept that diligence and patience are keys to prevailing. It needs to be understood that investing in quality improvement and analytics tools is unlikely to provide positive ROIs on next quarter's earnings. This process will take time.
While laying the foundation for value-based radiology started some time ago by a few individuals, #RSNA14 showed that finally, the collective effort of our profession is starting to further build the framework for a field that excels at quality and value. The journey will take time, but at least we're finally headed in the right direction.
Matt Hawkins is a pediatric interventional radiologist and an assistant professor in the department of radiology and imaging sciences at Emory University in Atlanta. He also serves on FierceHealthIT's Editorial Advisory Board.
Prior articles by the author:
RSNA 2014: What to expect (and hope for)
Patient-generated data: Re-evaluating the possibilities and necessities
Walmart and its implications for imaging
Re-recognizing the importance of radiology's professional community
H.R. 4302: Duct tape, delays and decision support
Reimbursement in medicine: One radiologist's perspective
Keeping score with revenue: The 2-step-back feedback
It's time to end diagnosis fragmentation
RSNA13: Business analytics, clinical decision support take center stage for radiologists