Although image interpretation is an essential part of radiologists’ value, there are other ways in which we contribute to patient care. Part II of the value of imaging series reviews current initiatives that demonstrate value beyond the image interpretation. Standardizing processes, reducing the radiation dose of our examinations, clarifying written reports, improving communications with patients and providers, and promoting appropriate imaging through decision support are all ways we can provide safer, more consistent, and higher quality care. As payers and policy makers push to drive value, research that demonstrates the value of these endeavors, or lack thereof, will become increasingly sought after and supported.
With payers and policy makers increasingly scrutinizing the value of medical imaging, opportunities abound for radiologists and radiology health services researchers to meaningfully and rigorously demonstrate value. In the first of a two-part report from the Radiology Research Alliance Task Force on the Value of Imaging in Healthcare, we described various definitions of value and outline challenges in measuring it from both the patient encounter and the larger societal perspective. In this second part, we detail several actionable opportunities for the imaging community to demonstrate its value to patients, payers, ordering providers, health systems, and society at large.
A survey of physicians on the most important health-care innovations in the last 30 years ranks computed tomography (CT) and magnetic resonance imaging (MRI) as the most important . But, as discussed in Part I of this series, defining and demonstrating the value of imaging can be difficult. Furthermore, although image interpretation remains the cornerstone of radiologists’ contributions to patient care, there are many additional opportunities for radiologists to add value to patient care. Boland and colleagues describe these steps in the first of his Imaging Value Chain series ( Fig 1 ) .
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Figure 1
Schematic representation of the imaging value chain, reproduced with permission from publisher (Elsevier). (Color version of figure available online).
In this second part of our series, we explore the value chain further and outline initiatives for academic radiology departments to consider in enhancing their value to patients, referring clinical practices, payers, and a variety of other stakeholders. These all represent actionable opportunities for radiology professionals to gather evidence to demonstrate their value and for innovative investigators to pursue new research.
Standardization
Numerous opportunities exist for radiologists to improve the value of imaging through standardization. Proper implementation with widespread support can result in the ultimate win–win: improved care with less cost. Variation is not only costly, adding some $700 billion in annual costs to our health-care system , but it also raises questions about the quality and efficiency of resource allocation and use—issues increasingly important in a fragile health-care delivery system with only finite resources. Although the sources of variation are not always clear, studies have demonstrated that variations in measures such as hospitalization rates depend on many factors other than illness . Nevertheless, it is impossible to build an evidence-based best practice guideline that perfectly fits all patients’ needs and preferences. The key is to eliminate unwarranted variation when evidence-based guidelines exist while recognizing that not every situation may be covered by guidelines or that patient preferences may require deviation.
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Imaging Appropriateness and Decision Support
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Patient–Radiologist Communication
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Referring Physician–Radiologist Communication
Structured Radiology Reports
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Radiology Consults
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Reinterpretation of Outside Radiology Images
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Conclusions
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Acknowledgments
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