Contributed by Anthony Gevo, senior vice president of Plexus Teleradiolgy, a unit of Integrated Medical Partners
Radiology, like the rest of health care, is in a transitionary period. Since 1930 to about 1990, we were in the period of Radiology 1.0, which was typified by the radiologist and the attending physician standing next to each other and looking at a film box. This was the era when the radiologist was referred to as the “doctor’s doctor.”
Then Radiology 2.0 happened. From about 1990 to 2014, radiology was typified by the digital transition in radiology. Film went away. Film boxes went away. There were tremendous upsides in new modalities and diagnostic techniques, but the downsides were pretty significant as well. Because of changes in reimbursement and patient involvement in care, the number of diagnostic images skyrocketed.
A very important downside to the digital radiology revolution was that the radiologists quit being the doctor’s doctor. Instead, they became nameless, faceless resources producing reports in dark rooms disconnected from the patient and in many cases, the hospital. A number of leaders in health care view the Medicare Authorization and CHIP Reauthorization Act and the new Medicare Incentive Payment System as a real opportunity for radiology to take a leadership role and once again become the doctor’s doctor.
The MACRA MIPS formula shifts the reimbursement from volume, transactions and reports over to the quality of care the patient is receiving. Experts propose doing this by shifting from Radiology 2.0 to what they call Enterprise Imaging 3.0.
The transition to enterprise imaging is going to expand imaging beyond radiology. Today, there are plenty of medical specialties that do not use the DICOM (Digital Imaging and Communications in Medicine) standard, for example. Cardiology has plenty of artifacts that don’t comply with DICOM. The same is true for pathology, dermatology and anesthesiology, and the move to enterprise imaging is going to address that.
This will coincide with a shift away from the all-in-one single-vendor PACS (picture archiving and communication system) or reading system to what many are calling a deconstructed imaging platform. As a cloud-based PACS provider, we are working toward vendor-neutral components like vendor-neutral archiving systems that can will store not just images from radiologists but also all other types of images that are involved in patient care.
These tools will erase the silo effect of current electronic medical records (EMRs) where even the best EMR cannot show all the information about a patient. With deconstructed imaging platform, DICOM images, waveforms, EKGs, invisible light, scanned documents, JPEG photos, will all be available from a single user interface. This will be the key for impacting the quality of care.
Radiology has always led the rest of health care in the adoption of standards and interoperability. In a value-based medicine future where quality will be defined as what impact did the particular treatment or procedure have on the patient’s care, it is poised to lead the way with an enterprise imaging approach.
Anthony Gevo joined the Plexus Teleradiology unit of Integrated Medical Partners (IMP) in March of 2016. He has more than 20 years of imaging industry experience. IMP is an RBMA Thought Leader partner.