By Shannon Werb
The pressure to demonstrate value in healthcare is more intense than ever; the requirement for robust, normalized, and data-rich analytics will only increase. Radiology has a unique opportunity to lead the imaging analytics conversation because—in theory—much of what we do can be measured, converted to metrics and benchmarks, and analyzed for insight that fundamentally changes our operating and clinical outcomes. That’s the nature of our highly digital specialty. In reality, normalizing disparate data sets, integrating information across facilities and practices, and extracting relevant information from the billions of images and imaging studies performed every year are hurdles that most have yet to overcome.
But the status quo is no longer an option. Radiology has already pulled the levers of working harder and longer hours; we cannot work ourselves out of falling reimbursement rates, changing reimbursement models (value vs volume), and the other challenges facing healthcare. The radiology profession must think its way out of these challenges and fundamentally change its approach in order to become an indispensable partner instead of a cost center to be managed.
Because of our practice scale and scope—over 500 radiologists reading 7 million+ studies for 2,200+ healthcare facilities around the globe—vRad has had to adapt more quickly than most. Transforming our practice first meant “measuring what we manage”—and that meant developing patent-pending tools with which to normalize the tens of millions of imaging studies in our clinical repository so that we could create the baseline and benchmarks with which to ask the right questions and make informed decisions for ourselves and our clients.
Asking the right questions is critical. I speak with a lot of fellow CIOs, hospital administrators, and practice leaders interested in how our practice has evolved and grown in such an uncertain environment. The conversation inevitably leads to the following question: “What technology offering is required to ‘fix’ my radiology practice (or imaging service line)?” My inevitable response: “That’s the wrong question.”
It may seem anathema for a CIO to say, but technology and its associated investments alone must not drive the conversation; they must inform the solution defined by the right questions, including (but not limited to): “What outcomes are we preparing for?”, “What problems are we trying to solve?”, “What do we want to look like once solved?”, and “What analytics and data will be required to provide the insight I need to help me solve this problem?”
That was our starting point and that is my advice to the radiologists, radiology administrators, and healthcare leaders who must meet increasingly complex economic challenges while providing quality imaging: start with the “what” and “why” before the “how” and your solution will be more effective and cost-efficient. The “why” must be informed by insight and analytics, rather than technology, opinion, or conjecture. Radiology can and must learn from its own data generated by the multitude of imaging studies done in the United States every year.
An example: Our practice was engaged by a client to evaluate a set of technology investments to consolidate radiology services across the multiple practices, facilities, and legacy IT solutions within their health system. As the largest, distributed, technology-enabled radiology practice, vRad was well positioned to advise—and “answer”—their questions. As a good partner, we did provide technical insight; as a better partner, we also told them they were asking the wrong questions.
To make our point, we leveraged the same data normalization tools and benchmarking metrics used by our own practice to develop a system-wide, 24×7 look inside their imaging services. It was the first time the client was able to “see inside their data” and develop a fact-based operating plan (the why)—to structure, prioritize, and manage not only their technology investments, but also their clinical resources (radiologists and referring physicians) and operational workflows (the how). Their insights and decisions were not based on opinions and conjecture, but rather on actual performance; reality is a much better metric to use to improve patient outcomes.
That is the power of imaging analytics. It starts with asking the right questions—and finding answers to questions you didn’t even think to ask.
At the end of the day, radiology will either learn to ask the right questions, embrace analytics, and become an indispensable partner by demonstrating a new kind of value beyond the reading room … or end up in the dark. I know where our practice—and our clients—want to be.
About Shannon Werb:
Werb is chief information officer for Virtual Radiologic (vRad), the nation’s largest telemedicine company and radiology practice where he is responsible for all aspects of vRad’s technology platforms and data assets. Werb also drives collaboration and partnership with vRad’s clients to navigate a radically changing healthcare environment.
For over 20 years, he helped organizations develop enterprise solutions to deliver data to medical personnel faster and more cost-effectively, resulting in improved clinical processes and an overall better patient experience.
He writes a bimonthly column about radiology analytics and data issues for AXIS.