What is going on right now in radiology?
In general across the industry, there seems to be a lot of consolidation of groups.
I think the big concerns, or what people are focusing on, is the ability to provide 24/7 service, subspecialty capabilities, and being able to even out the workflow.
There is a lot of interest in groups either merging or working together in a cooperative way to provide the 24/7 service. Radiology is really trying to figure out where it fits in with the activity around electronic health records and health information exchanges. I don’t think any of us know what the answer is for that.
I think like most, there is a lot of uncertainty, but I think for radiology there is even more uncertainty. We have radiology information systems (RIS) with patient records and they are electronic, but they really don’t have the functions, as defined by the government, as an electronic health information record. You know patients don’t access an RIS; we don’t have portals for patients to get into. They really see the physician in the hospital as a record keeper, and we just provide a portion of that information.
The challenge becomes, for groups like ours, that in order to support the number of physicians to provide 24/7 service with subspecialty readings, you’d have to be able to provide service to multiple hospitals to have enough volume to support that many physicians.
Even with the current uncertainty, what are the focus areas or recent successes for your department?
In terms of successes, you know we have had some success in the billing area. We are using our dictation system at all of our sites; that is one thing we have been successful at. Getting all of our hospitals, even the two local hospitals, onto our dictation system means we have a real nice opportunity to take advantage of to improve the practice from a billing perspective.
Currently, we have a single flow for how we get reports to billing. At other organizations, if you work with multiple hospitals and practices that provide professional radiology, odds are you have multiple workflows for how you get your billing information.
Billing information comes from two different places for professional radiology. We get information from the report itself and from registration. The report has the clinical information that is necessary to get paid, and the registration information gives us the guarantor information, insurance information, street address and date of birth that are required.
Billing is just ridiculous in terms of what we have to do to get paid. Nobody is doing anything about that. Actually, they are making it worse, but nobody seems to care. Sure, the government thinks they are going to save money. It includes cost to accomplish these savings, and it’s going to be our cost.
We’re fortunate our provider community uses our dictation system. That gives us at least a single point to get report information in a consistent, standard way. That is actually a huge victory for us, yet it is only half the battle. The other half is registration, which is a bigger nightmare. At least we have the report information in a standard format. We’re working hard to get the billing information in a standard format, but that likely will be a hurdle we may never overcome. No one has targeted that as something that needs to be on the agenda. The agenda is totally oblivious to what the real problems are.
What do you predict will happen within radiology in the next 5 years?
Well, certainly health information exchanges. It doesn’t take much of a psychic to figure that one out, if you can do it. I think the other thing for us is a much better way for physician practices to be able to put an order into their system and then for us to receive that order into ours. After we produce the patient report, the data flow back to the referring physician would be automated back into their system, and they can verify that they got it. What we need is to know that they got it, and they read it. That would be awesome.
Won’t the HIE solve that for you?
Not likely in the near term.
Joe Moore is the CIO at Radiology Consultants of Iowa. As Iowa’s largest group of radiologists, Radiology Consultants of Iowa (RCI) has been providing Eastern Iowa communities with radiological services for more than 70 years. At RCI facilities, they offer the latest in high-technology medical imaging services such as High Field (1.5T) MRI-MRA, Open MRI, Spiral CAT Scan, Ultrasound, Color Doppler, Mammography, DEXA and QCT Bone Densitometry, SPECT Nuclear Medicine, Positron Emission Tomography Imaging (PET) and Computed Radiography (CR). / RCI takes pride in their staff of Board Certified radiologists who have advanced training in the areas of Nuclear Medicine, Neuroradiology, Muskuloskeletal Radiology, Chest Radiology, Body Imaging, Mammography, Ultrasound, and Interventional Radiology. www.rciowa.com