Stage 2 and the Shift to a Patient-Centric Radiology Workflow

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Doug Rufer, North American Business Manager, RIS, Healthcare Information Solutions, Carestream

The final measures of stage 2 meaningful use start the 2nd chapter in changing the way all specialties will practice medicine.  For radiology, incorporation of patient images into the patient’s clinical record as a specific measure opened the door for future legislation that will take into account other specialty needs as future stages are rolled out.

The goal of meaningful use has always been to provide both clinical and technological avenues to share patient medical information without boundaries to those who require it to improve quality of care and reduce overall costs.  By adding medical images to the mix, the door has been opened for improved access to patient images, thereby reducing repeat exams; and from the patient perspective, decreasing overall patient exposure to radiation.  However, these changes are sure to propose challenges for radiology going forward.  Radiology is typically practiced as a departmental approach, not a patient centric approach.  Additionally, radiology has been the gatekeeper of the medical imaging record, not the EHR; and to date, there are no standard-based image archives and viewing platforms that allow any EHR access to patient images regardless of vendor or location; and this is where the opportunity for medical imaging vendors begins.

Providing measures to incorporate medical images into the EHR sets the stage for better image access, but one major hurdle still exists: how does one access the thousands of imaging silos of information?  Additionally, how do we create a standards-based, not simply vendor-neutral, open access image archive accessible by those who need it the most – the patient and their primary caregiver?

Meaningful Use will forever change radiology’s workflow. The new path keeps the patient at the center of care. This paradigm shift will prompt new technologies and new methods for practicing radiology as the future unfolds.

Consider the following:

• Radiologists must focus more on the overall clinical condition of the patient when making an exam diagnosis, rather than the short patient history taken at the time of exam.  This change emphasizes overall patient outcomes, not just imaging outcomes.

• Access to the complete patient record and forthcoming decision support rules will aid radiologists in taking a more holistic approach to image diagnosis.  While this will take more time in exam interpretation, overall patient outcomes can improve significantly.

• Barriers to image access that exist today must be overcome to allow easier access across any platform for viewing.

• New mobile technology must be developed to provide anytime/anywhere access to the patient record and images, further reducing the barrier to information.  This will further virtualize the medical industry.

• Technologists must now focus on capturing better patient histories using a structured data approach during the exam to help radiologists better collaborate with the overall patient record and produce better reports that provide better data mining capabilities.

Although we’re still in the infancy of rolling out a more patient centric model of care that encompasses all medical specialties, radiology must begin to adapt today to prepare for the changes of tomorrow.  No longer can a radiology practice afford to focus on the inherent imaging needs of the patient, but rather the overall goal of improved patient outcomes needs to take front and center stage going forward.  The advent of new technology must take place for our reformed healthcare model to succeed. As you consider technology purchases today, make sure your vendor is devoted to developing the tools necessary for the future.