Radiology Metrics in Value-Based Care
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Applying metrics of value-based care to radiology.
The shift to value-based care (VBC) requires healthcare providers to demonstrate improved value. But how do you define value? And what are the metrics for radiology to demonstrate improved outcomes?
Michael Porter, Bishop William Lawrence University Professor at Harvard Business School, and Elizabeth Olmsted Teisberg, Executive Director of the Value Institute for Health and Care at The University of Texas at Austin Dell Medical School define value in Redefining Health Care as “the health outcomes achieved per dollar spent.” (1) The authors, who were early proponents of value-based care, additionally state, “improving value requires either improving one or more outcomes without raising costs or lowering costs without compromising outcomes, or both.”
So how can radiology prove that it is improving outcomes without raising cost? Or lowering cost without compromising outcomes? Some metrics are obvious, like reducing unnecessary duplication of studies, and improving the quality of our reports so they convey information more clearly. These we can embrace immediately. Others can be proven with the help of collaborative evidence.
Eliminate duplication of images through enterprise image access
When we can avoid taking duplicate images by making image access available to any clinician who is part of the care team, this is a win for the patient. With secure access to images, results are available faster, patients are happier not to have to undergo an unnecessary procedure (even if the dose was not an issue), and we avoid the cost of a duplicate procedure. How much cost do we save? How does immediate access to relevant images add to a faster, more effective patient outcome? We need to collect the evidence.
Informed radiologists can provide more accurate, clearer reports
When we provide radiologists two-way access to the EHR, patients can benefit from a more informed read, radiologists can be more productive, and there is less room for mistakes to be made. In a Radiology Today article, recapped in Everything Rad, Dr. Cree Gaskin of UVA believes radiologists are “missing a tremendous opportunity if they don’t embrace multi-media reporting…” with text and key images, quantitative information in the form of tables and graphs—including hyperlinks to key regions of interest on specific images and bookmarks that take users directly to relevant priors. This type of report allows the referring clinician a quick grasp of the study, ultimately making collaboration with the radiologist much easier.
Suppliers, like Carestream, can do more in a value-based environment
In Redefining Health Care, the authors point out that “Suppliers can add far more value to health care delivery than they have yet realized” (1). As a supplier for a hospital or physician group that is in transition from fee-for-service to value-based care, Carestream can provide technology to help support their goals.
Quantifying value of radiology requires collaboration across the enterprise
What the authors suggest is that siloed departments do not thrive in an environment of value-based care, because their contribution to the health and the well-being of patients is not always clear. Both radiologists and referring physicians can be more productive through a collaborative relationship. With more complete information, a radiologist is in a position to suggest an imaging protocol that more quickly identifies a patient’s condition which can lead to a better outcome. With more complete information from the radiologist, the referring doctor can arrive at a solution that is not only more appropriate, but less costly. The cost savings can be analyzed in terms of reduced hospital admissions, increased productivity, and increased patient satisfaction.
Population health data can add to our appreciation of radiology’s contribution to healthcare
Today we have the ability to scan large volumes of radiology images and mine their contents for a snapshot of a hospital’s population, which provides a benchmark for future comparison. It’s this kind of evaluation that allows us to truly understand the ongoing and increasing value radiology contributes to health care.
To this end, in the Carestream Clinical Collaboration Platform, our analytics module has a dashboard that can query available studies and aggregate and present the data as a population statistic according to a number of factors. One example is bone health, where factors like T scores and Z scores which look at bone density can help us understand risk for osteoporosis. Because the data is available on an individual study, but also on a site wide or even enterprise basis, radiology now has the tools to compare a population to a broader group—a healthcare strategy that not only helps the patient, but possibly others as well. Besides osteoporosis, the Carestream analytics can also look at scanned images to indicate risk for emphysema, fatty liver, and coronary calcification. This type of insight into population health has the potential to change the way we address some of the most serious health issues of our time.
Radiology needs to be more involved with outcomes
At Carestream, we believe that the era of the radiologist locked in a dark room, reading studies 8 hours a day, and isolated from the rest of the hospital—is over. In today’s value-based health care, radiologists must establish themselves as key team members. Because radiologists have the answers referring clinicians are seeking, they can use collaboration to provide additional insight and value in the form of quicker diagnoses, faster recognition of the results of treatment, and of course, overall better outcomes.
Read the related blog on how medical imaging technology can support value-based care.
#valuebasedcare #VBC #radiology #everythingrad
- Porter, Michael E., and Elizabeth O. Teisberg. Redefining Health Care: Creating Value-Based Competition on Results. Harvard Business School Press, 2006.