From the January/February issue of HealthCare Business News magazine
By Michael Gray
The concept of value-added radiology (VAR) embraces a number of objectives — from initial involvement with care team physicians in determining the correct study to order, to improving the quality of the interpretation and turnaround time.
This VAR concept coincides with the shift in radiology from volume- to value-based reimbursement. Perhaps a more fundamental point of VAR should be elevating the radiologist’s role above merely interpreting the imaging study…basically interpreting the study in a more holistic (and accountable) manner and not based on the images alone.
To be more involved through the entire process, what the radiologist needs is easy and rapid access to the clinical information on the patient that is relevant to the radiology study and therefore context sensitive. Unfortunately, radiologists are frequently limited from seeing the broad range of clinically relevant information related to the patient’s condition. Most PACS can only provide access to those prior radiology reports and associated images that are stored on the specific PACS being used. The PACS might additionally provide access to the electronic forms or scanned documents containing procedural notes, calculations and measurements that were contributed by the technologist.
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The scanned documents typically contain only that clinically relevant information collected during the patient’s visit to the department. In addition to the PACS, the Radiology Information System may provide access to the original order and thus the reasons for the requested study, and perhaps a summary of the patient’s history. That’s it!
Even when the above information is accessible, searching through an unstructured collection of electronic documents in the PACS or the RIS to discover more than the reason for the order is often considered by many radiologists to be too cumbersome and time-consuming to be worth the effort.
In any case, the real source of the patient’s longitudinal clinical information is the EMR, where the radiologist could discover the patient’s complete medical history, the care summaries, results from imaging procedures beyond radiology as well as non-imaging procedures (i.e. pathology), lab results, surgical history, etc.
While the EMR is a vast repository of clinical data, like a three-ring binder of information organized by tabs, this data is frequently not accessible through the radiologist’s diagnostic workstation, and logging into the EMR directly makes the process of accessing and searching for patient-specific information a burden on the radiologist. Beyond that, most radiologists are used to working in a highly visual and efficient environment (very few clicks). This is in direct contrast to the way the radiologist would have to consume data from an EMR, which is highly textual and a click-heavy user experience.