Managing the Flow in Radiology
It?s Free and It?s 3D!
If your radiology practice is still providing referring physicians with faxed or e-mailed two-dimensional reports or a CD due to PACS viewing software license fees, a new free solution is now available.
FiatLux Imaging Inc, Redmond, Wash, is currently offering Visualize FREE. As the name says, the software is a free, DICOM-compatible CT or MR 3D visualization software that?s available for anyone to download, including patients and referring physicians.
Offering free medical informatics software is a growing trend in the marketplace. For some vendors, revenue is derived indirectly through manufactured Web advertisements. For FiatLux, the point is to introduce potential physician clients to a new platform that may lead to a premium upgrade or other paid informatics solutions. Advertising may also appear on the forthcoming online version.
Max Lyon, CEO of FiatLux, refers to the revenue model as a ?freemium? model. He said that the company had originally developed the solution targeting radiologists, but eventually decided to reshape it for referring physicians, specialists, researchers, and others who often don?t have access to 3D visualization software.
Lyon said, ?When we talked to specialists about their need for images and their use of them, they were very frustrated because there aren?t good methods to get these images from the imaging center, or view these images, or store these images. So it became clear to us that there really does need to be a system like this.?
FiatLux released Visualize FREE in 2009 in order to build a new user base and also to gather feedback for helping complete development of the company?s next-generation viewing platform. This next online version will include review, analysis, archiving, and sharing features.
The company?s goal is to deliver an open, yet secure platform. Lyon explained, ?What we?re creating is an Internet-based open system for the transport, viewing, storage, and sharing of medical images. It will be a platform where images can be uploaded from anywhere in the world to a secure cloud location, and then stored into a specific physician or institutional account where most imaging studies could be accessed from any computer, including the patient?s.?
Lyon described Visualize Free?s next generation viewer as something that will look more like a video game, in that it will be intuitive and easy to use by anyone, including a patient.
In addition to 3D visualization tools, the next version of Visualize FREE will be able to host virtual online meeting areas, where patients and/or referring physicians can simultaneously be online and consult about the shared images in front of them. Online meeting participants will also have the option to segment out areas, rotate the area in 3D, slice through images, and more.
In addition, unlike the current version, you won?t have to download the program. The current installation process can take a couple of hours, even with a high-speed Internet connection. Also, the current free version requires at least 300 MB of available hard drive space, plus a recommended 80 gigabytes for image storage.
Lyon said that once the company releases the new Web-based product, there will still be a free level of service that will be ideal for patients who need only a limited amount of storage.
Radiologists, other medical specialists, and researchers who use Visualize FREE on a daily basis will pay some type of monthly subscription that may be relatively low thanks to advertising and sponsorship.
As of mid May 2010, Lyon reported that the company has had more than 2,000 downloads of the current viewer, with 500 regular users and about 5,000 studies viewed and reviewed.
Users are comprised of mainly specialists and referring physicians, although Lyon added that there are a few radiologists as well. The company expects to complete and launch the full online service in 6 to 8 months.
Migrating to a Revenue Cycle Management System
The switch from a hodgepodge of software systems and modules to one enterprise-wide, centralized system is not necessarily easy, but for some hospitals it is necessary. ?For all of the revenue cycle systems, it is a 100% replacement of the core patient management and patient accounting systems along with scores of boltons. So by definition, it?s a little bit more complex and more time-consuming,? said Ajit Sett, vice president of revenue cycle solutions for Siemens Healthcare, in Malvern, Pa.
The benefits, however, are worth it. Management of the system itself immediately becomes easier because there are fewer programs to maintain and troubleshoot, as well as less expense through reduced support and licensing fees. Management of the revenue cycle also becomes easier, automating workflows, streamlining processes, improving collections, and facilitating tracking and reporting enterprise-wide, as well as through the entire health continuum.
?It is the interconnectivity of all the different workflows within the revenue cycle, through scheduling, error correction, claims completion, claims creation, remits management, AR management, etc. Organizations want to make sure that all of those things are taking place from the same core system,? Sett said. That connectivity extends throughout the entire enterprise, linking multiple systems and subsystems, including clinics and other remote services.
The Three Drivers
The ability to view the entire enterprise?s current financial situation enables leadership to understand the true enterprise margin for an episode of care. Sett notes that there are three major drivers behind institutional migrations to revenue cycle solutions: market imperatives, business objectives, and operational improvement agenda?in that order. ?It?s the market imperatives that are driving many of these organizations to switch,? Sett said.
Health care reform legislation, cost pressures, and current industry trends are changing the business models that have previously supported health care. Sett foresees a future in which health care is provided based on global payment methodologies. ?We have this new concept of accountable care organizations that would accept responsibility for all the care of all of their enrollees,? Sett said.
As a result, contracting health care organizations must assume both performance risk and insurance risk. ?As they are assuming those risks, they are looking for systems that allow them to get a clear understanding of revenue, cost, and margin per episode of care. Multiple systems can no longer be kluged together to ?operationalize? revenue cycle operations,? Sett said.
If the market imperative is not driving the hospital, then the organization?s business objectives may drive the need for similar changes in revenue cycle technology. Health care providers used to focus on the total cost of operations, but as they extend services throughout the community, greater efficiency and cost per episode of care become the major metrics.
?There are organizations that have a very high incidence of net revenue loss because of denials, payment errors, etc,? Sett said. To improve their functional capabilities and achieve their business objectives, institutions may be driven to migrate to a revenue cycle solution.
Others may be driven simply by an operational need. ?When you look at the overall architecture of the traditional mix of revenue cycle systems, you?ll find many health care providers have a core patient management/patient accounting system and as many as 20 to 40 different subsystems and bolt-ons added to that core system,? Sett said, adding that in some instances the cost of managing the subsystems exceeds that for the core HIS.
Now or Later?
New systems can also help health care providers meet the goals established by regulation, such as ?meaningful use? requirements, more easily. So rather than undertake the labor and expense needed to prepare numerous software programs, some organizations are choosing to migrate now. ?A provider executive recently mentioned that he had as many as 27 major systems that would have to be remediated for ICD-10 readiness,? Sett said.
Having one system eliminates this complication while improving revenue cycle management throughout the entire enterprise. Whether an institution is driven by market imperative, business objectives, or operational environment, it is keeping its eye on what?s ahead. ?I see a lot of organizations right now that are focused on making sure they have these systems for the future,? Sett said.