"Innovation is the key to our future." That's the slogan for #RSNA15. Innovation--of course--can be interpreted in variety of ways, though.
There is the scientific and technological approach to innovation. This approach results in new ways to image the human body, advance science, treat various ailments and diagnose disease. MRI elastography, novel radiopharmaceuticals, 3-D printing from DICOM data and further fMRI advances fall under this definition of "innovation." These advances are an absolute necessity for our field to continue to thrive in healthcare's future. But they come at tremendous cost--and often result in only small incremental improvements over technology that is already ubiquitously available. The excitement surrounding these Star Trek-like innovations deems them worth the dollars--or so it seems. These exciting scientific imaging-based applications pave the way for academic careers and receive extensive attention at national meetings. They are the driving force behind journal articles entitled, "A single-institution's initial experience with Technology X" or "Intermediate results in patients treated with Technology Y" or (my favorite) "Pilot study of Technology Z to evaluate feasibility and efficacy of implementation."
(Disclaimer: I, too, work at a wealthy, academic institution that provides the environment in which studies such as these can take place.)
And please don't misunderstand--despite my satirical prose--I believe scientific, imaging-based innovation is vital. Absolutely vital.
But lost in the fanfare are practice management, data measurement and business analytic innovations. The other kind of innovation. These often allow radiologists to optimize utilization and capabilities of tools that already exist. Current scanners can be optimized to deliver appropriate radiation doses. Trend analyses can refine how radiology groups staff their practices during nights and weekends. New practice models that effectively utilize non-physician providers may be able to reduce the cost of episodes of care. Radiology groups who have embraced effective peer-review systems can reduce the number of errors experience by their patients. Telehealth consulting tools have connected clinicians and patients to radiologists, often reducing unnecessary imaging tests. Contemporary radiology reporting software can craft reports that are valued by patients and referring clinicians.
We are entering a risk-sharing, alternative payment model era in which radiology will be a cost center. The days of making money every time a patient goes through the scanner are numbered. Reducing errors, increasing value, lowering cost and improving outcomes will be the factors that reward the best radiology groups, and penalize the others. No longer will hospital administrators be looking for a "new expensive toy" that they can advertise on an interstate billboard. Rather, they want data that will show insurers that patients treated at their facilities have better outcomes at reasonable costs and allow them to model risk-sharing reimbursement. The value of radiology will be molded by perception and demonstrated by healthier patients and less expense. There are no CPT codes or RVUs for that.
We must continue to value, fund and celebrate imaging-based innovation, clearly. But innovations that impact the "less-scientific" fabric of our practices and our profession should be celebrated, as well.
If I truly believed that we were optimally using all of the remarkable scientific innovations that are currently at our disposal, my message would be less blunt. But we're not. And so it is.
Is this the year that radiology turns the corner? The questions, commentary and hallway discussions at #RSNA15 will tell the story.
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.
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