Imaging’s Perfect Storm

/in , /by
Image shows a sailboat in stormy weather.

The New Normal

Recently, Radiology Business discussed the top seven challenges that are impacting radiology practices today, and this is setting up imaging’s perfect storm.  In the past 20+ years, imaging has witnessed some impressive changes (film to digital, Meaningful Use, improved workflow tools, and artificial intelligence (AI) – to name a few.  However, as impressive as those changes are, challenges still exist.  Reimbursements continue to decline, staffing shortages persist, new regulations continue to challenge imaging, and older IT solutions are not designed to improve today’s workload efficiencies.

The article above mentions seven primary challenges. They are declining reimbursement, organizational consolidation, an inadequate labor force, imaging appropriateness, staff burnout, turf wars between radiologists and other non-physicians, and a decrease in workflow efficiency. The question is, can technology help improve any of these challenges to help ward off a perfect storm in medical imaging?

Declining Reimbursements

Outdated reimbursement models make it more difficult for clinicians to provide quality care.  Legislation is continually discussed to target reimbursement reductions, and this ultimately can have an impact on patient care.  Even the public is strongly opposed to reducing reimbursements to physicians. 

Technology plays a crucial role in mitigating the impact of reduced reimbursements in radiology. Advanced software solutions, particularly those powered by AI, can significantly improve the efficiency and accuracy of medical coding and billing processes. Some of these AI-driven systems (like AI driven reporting from MD.ai), can analyze radiology reports, automatically assign the appropriate billing codes, and ensure compliance with ever-changing reimbursement rules. By reducing coding errors and optimizing claim submissions, healthcare providers can maximize their reimbursement rates and minimize claim denials.

Advanced Picture Archiving and Communication Systems (PACS) and Radiology Information Systems (RIS), like the solutions offered from InsiteOne can improve overall operational efficiency. streamline workflows and reduce turnaround times.  These improvements allow radiologists to handle higher study volumes without compromising quality. AI-assisted image analysis tools can prioritize worklists, flag critical findings, and even provide preliminary reads, enabling radiologists to focus on complex cases that require their expertise. This increased productivity can help offset the impact of reduced reimbursements by allowing practices to maintain or even increase their study volumes while controlling costs.

Organizational Consolidation

Mergers and acquisitions will continue, and healthcare is not immune.  One way for hospitals to remain competitive and offer better services is through acquisition.  However, this creates challenges for radiologists as it shrinks the pool of locations they can contract with independently.  Oftentimes, they may be forced to work for an organization as an employee, losing any benefit they had as an owner of their own practice.

Although technology will not stop mergers and acquisitions, it can help with integration of the organizations once merged.  Technology can facilitate consolidation by providing scalable and interoperable solutions. Cloud-based PACS and RIS solutions enable seamless integration of imaging data across multiple facilities, regardless of their geographic locations. With centralized storage, retrieval, and sharing of medical images and patient information, continuity of care for patients is assured as health systems merge or expand. Advanced data analytics tools can help identify operational inefficiencies, standardize best practices, and optimize resource allocation across their network. Moreover, teleradiology platforms enable radiologists to provide remote readings and consultations, effectively distributing workload and expertise across the entire health system.

Inadequate Labor Force

Labor refers both to technologist shortages as well as radiologist shortages.  When it comes to technology to address this, advanced RIS and PACS solutions that provide enhanced workflows around study prioritization, automation, and streamlining processes can allow staff to do more with less.

AI solutions can augment and streamline imaging workflows. AI-powered algorithms can pre-screen large volumes of medical images, prioritizing urgent cases and flagging potential abnormalities for radiologists to review. This triage system allows radiologists to focus their expertise on complex cases, effectively increasing their productivity without compromising quality. AI can also assist in routine tasks such as measurements and comparisons with prior studies, reducing the time radiologists spend on these activities. Furthermore, clinical AI solutions can serve as a second pair of eyes, potentially catching subtle findings that might be overlooked during high-volume reading sessions. By handling time-consuming preliminary analyses and supporting decision-making processes, AI technology enables radiologists to manage larger caseloads efficiently, while not compromising care.  Additionally, AI used in screening scenarios can help sift through volumes of images and finding incidental findings, such as pulmonary embolisms, that can improve patient safety.

Imaging Appropriateness

The overuse of imaging, particularly by non-physicians, is a growing concern. This trend is driven by factors such as defensive medical practices, patient expectations, and the increasing availability of imaging technologies. Non-physician providers, often lack the specialized training of radiologists, and may resort to ordering unnecessary studies as a precautionary measure or due to uncertainty in clinical diagnosis. This not only contributes to rising healthcare costs but also exposes patients to unnecessary radiation and potential false positives, leading to further unnecessary interventions. The challenge lies in striking a balance between providing comprehensive care and avoiding the pitfalls of overutilization.

In emergency departments, overutilization of medical imaging stems from an intolerance for diagnostic uncertainty. Emergency physicians, also faced with time pressures and the potential for high-stakes medical decisions, may lean heavily on imaging studies to rule out serious conditions, even when clinical judgment might suggest otherwise. This surge in imaging requests, however, does not always align with the available resources in radiology departments, creating bottlenecks and potentially delaying critical care for those who truly need it. Technology, such as clinical decision support (CDS) solutions and integrated into electronic health records, can guide clinicians towards appropriate imaging choices based on evidence-based guidelines and patient-specific factors. Technology, along with better training for non-physician personnel, when implemented thoughtfully, has the potential to optimize imaging utilization, without compromising care and further straining radiology resources.

Staff Burnout

Most radiologists are reading beyond their daily capacity and this continuation can lead to burnout.  Increasing work hours, excessive study volumes, and the psychological strain associated with interpreting complex exams, can lead to feelings of exhaustion and dissatisfaction. Many radiologists find themselves overwhelmed by the pressures of their roles.

The constant influx of complex imaging studies, coupled with the need for rapid turnaround times, can further lead to mental and physical exhaustion. AI technology offers several promising solutions to alleviate burnout with image analysis, flagging potential abnormalities and prioritizing urgent cases. AI powered voice recognition software and automated reporting tools can significantly reduce the time spent on administrative tasks, freeing up radiologists to concentrate on image interpretation. Finally, workflow optimization systems can help balance workloads more effectively, ensuring a more manageable distribution of cases among team members.

Turf Wars

Increasingly, imaging studies being ordered – and in some instances interpreted by non-physician personnel can further strain today’s healthcare system.  This practice, often driven by the desire for quick diagnoses, insistence from the patient, or even financial incentives, can lead to misinterpretations, unnecessary follow-up studies, and potential patient harm. Radiologists, who have undergone years of specialized training, frequently find themselves in the position of having to review and correct these interpretations, adding an extra layer of work to their already demanding schedules. This situation not only increases the workload for radiologists but also creates tension between specialties.

The rift deepens when non-physicians insist on their interpretations or order inappropriate studies, forcing radiologists to navigate delicate professional relationships while ensuring patient safety. Moreover, this practice can lead to inefficient use of imaging resources, increased healthcare costs, and potential delays in accurate diagnoses for patients who truly need expert radiological assessment. As a result, many radiologists advocate for stricter guidelines and better education for non-physicians regarding appropriate imaging utilization and the importance of expert radiological.  Much of this will rely on health systems limiting or highly regulating the use of non-physicians participating in imaging studies or interpretations, as well as legislation that provides better education and guidance to make sure that non-physicians work harmoniously with practicing radiologists.

Improve Workflow Efficiency

Efficient workflow practices can make all the difference in the word when it comes to handling more work than one can physically manage.  If solutions help to streamline processes, often reducing manual intervention, interruptions, or outdated processes, and improve throughput in healthcare organizations.

Furthermore, radiologists spend about 36% of their time actually interpreting images, meaning the remainder of their time is spent consulting with other physicians and staff, struggling with outdated technology, continuously being hampered by administrative burdens that do not contribute to patient care, and other daily disruptions.  Implementing AI into workflows can improve efficiency, while paying attention to reading room ergonomics, can both go a long way in providing a better environment for radiologists to practice, while improving their overall mood, efficiency, and ultimately help reduce burnout.

Averting the Perfect Storm

Radiology is facing challenges from many fronts and attention must be given to help avert what is becoming a perfect storm that could negatively impact patient care in the future.  Health systems need to recognize the value that radiologists bring to the overall care of the patients they serve and focus on ensuring they have the right mix of tools, technology, and working conditions to allow them to manage the increasing patient study volumes they are experiencing.  Most health systems are using outdated technology, so the opportunity to modernize infrastructure and solutions with today’s newer, more efficient solutions is one path that can be taken to improve the situation radiology is facing.  Additional focus on reducing regulatory limitations, stopping constant payment reimbursements to radiologists, improve physician recruiting, remove administrative burdens, and provide increased job flexibility to help alleviate the challenges radiologists are facing today.

Consider InsiteOne for Modernization

InsiteOne has evolved with decades of experience as a vendor that that offers simplified to comprehensive workflow automation and storage solutions to the imaging industry, supporting many of the topics presented in this month’s blog.  By offering a modern, comprehensive suite of workflow solutions to meet your individual needs, InsiteOne is paving the way to help radiology practices make the impossible, possible.

Our cutting edge, cloud-native PACS, RIS and VNA are designed to optimize efficiency while improving overall radiology operations, all at a cost that works, regardless of the size of your organization.  Want to learn more?  Give us a call or click here to start a conversation with one of our experienced team members today. 

If you’re heading to RSNA24, consider scheduling some time to meet with us or simply stop by booth #1737 in the South Hall and let’s start a conversation!

The Exodus of Radiologists from Large to Small Groups

/in , /by
Burned out radiologist.

Change is in the Air

The landscape of radiology is experiencing a notable transformation marked by a significant trend of radiologists departing from large radiology groups to join smaller, more independent groups and practices.

At the heart of this movement lies a complex interplay of factors, each contributing to the changing dynamics of the radiology profession and pushing practitioners to reevaluate their career trajectories.  Chief among these driving forces is the rising incidence of burnout. Additionally, the rapid advancement of technology is another major factor. Not only has technology revolutionized diagnostic imaging but new avenues for improving practice management and remote work opportunities are much more prevalent. Finally, new healthcare models have evolved, such as value-based care. Add to that personal, financial, and professional satisfaction and one can begin to understand the shift. But these changes present new challenges and opportunities for today’s radiologists.

Burnout: A Leading Factor

Burnout is probably the number one factor that drives radiologists to smaller groups and practices.  The demanding nature of their job, which includes long work hours, excessive patient volumes, and the psychological strain associated with interpreting complex medical images, can lead to feelings of exhaustion and dissatisfaction. Many radiologists find themselves overwhelmed by the pressures of their roles.

In contrast, smaller radiology groups frequently provide a more relaxed and supportive work environment. This allows radiologists to achieve a better work-life balance.  Plus, smaller practices tend to have fewer administrative burdens. This enables radiologists to dedicate more time to patient care, which ultimately leads to improved job satisfaction.

Technological Advancements

Technological advancements like cloud computing, the growth of artificial intelligence (AI), new advanced workflow orchestration and reporting solutions that incorporate AI, are all reducing the burden for today’s radiologists by allowing them to work faster and more efficiently with greater accuracy.  However, even with these impressive advancements, feelings of job insecurity and anxiety can still affect radiologists’ mental well-being, as many worry that they will be replaced by machines (although that scenario is highly unlikely).

Larger radiology practices may have the financial ability to invest in new technologies but are often heavily invested in long-term arrangements with early vendors they partnered with.  This may lead to spending less on new technology adoption, often staying with solutions offered by their preferred partners.  Smaller groups often do not carry legacy relationships, making technology adoption much more agile. 

Changing Healthcare Landscape

The shift towards value-based and patient centric care models, as well as population health management initiatives has introduced new challenges (such as increased pressures to reduce costs and improve overall efficiency) for radiology groups and may have a bearing on their desire to join smaller groups. Smaller practices may be better equipped to navigate these on-going changes, as they typically possess more flexibility to tailor their services to meet the specific needs of their communities. This adaptability can lead to improved patient outcomes and greater satisfaction for both patients and providers.

Financial Considerations and Professional Satisfaction

It may seem counterintuitive but smaller organizations may offer higher earning potential for radiologists.  Besides competitive salaries, providing a “skin in the game” financial approach, these smaller organizations provide a financial stake in the business as it begins to grow and this offers a better correlation between work effort and financial rewards.

Smaller organizations may also be more open to pursuing new revenue opportunities while expanding the services they offer.  Using profits from these new ventures may be used to invest in new cutting-edge technology or new service lines.  Furthermore, physicians in smaller practices often have a personal stake in the overall growth of the group, providing them with a vote in new avenues the business is taking.  This helps to improve their overall satisfaction with the company they work for and encourages creative contributions to elevate their group competitively.

Professional satisfaction derives from more autonomy the members are often afforded in smaller groups.  Instead of adhering to strict rules implemented to provide consistency and scale, the desire to provide more personalized clinical decision-making while implementing best practices with fewer constraints is rewarding to many radiologists.  Better work life balance, improved care teams, reduced administrative burdens, and flexible work options all lead to higher professional satisfaction that smaller groups often provide.

Changing Market Dynamics

Radiology has evolved from a fee-for-service model to new care models like value-based care, opening the door for radiologists to expand their professional duties.  Radiologists are becoming more focused on being the “physician consultants”, or the doctor’s doctor.  Increasing consultations decreases the time radiologists have for reading new studies.  But providing clinical consultations improves their value to healthcare organizations and leads to better patient outcomes.  When radiologists are part of a patient’s clinical care team, better collaboration results in better care pathways, further improving patient outcomes. 

As these shifts continue, the need for even more subspecialty expertise and adaptive care models will continue to grow, making the smaller practice more agile to champion and adopt these changes.

Weighing the Pros and Cons

While the trend towards smaller radiology groups is gaining momentum, it is essential to recognize that there are still advantages to working within a large group. Benefits like access to advanced technology, greater financial stability, and opportunities for specialization are just a few reasons some radiologists will choose to stay with larger groups. Large groups often have more resources to invest in cutting-edge equipment and provide comprehensive training. However, many radiologists may still desire more autonomy and personal stake in their group, driving them to leave the large groups in favor of a more fulfilling and rewarding career at a smaller group.

What Do You Think?

The exodus of radiologists from large groups to smaller practices is a multifaceted phenomenon driven by a multitude of reasons, as mentioned in this blog.  Smaller practices may offer a more supportive work environment, greater autonomy, and the flexibility to adapt to new challenges, while large groups provide financial stability, valuable resources and opportunities for growth.  The appeal of smaller, independent practices is becoming increasingly attractive to radiologists seeking a more balanced and satisfying professional life. As this trend continues, it will be interesting to observe how the dynamics of radiology continues to evolve and how both large and small groups adapt to meet the needs of their practitioners and patients alike.

InsiteOne Provides the Foundation

InsiteOne has evolved as a vendor that supports the workflow and technology needs of smaller radiology practices.  By offering a comprehensive, yet cost effective suite of workflow solutions, InsiteOne is paving the way to help this new breed of smaller radiology practices grow and flourish.

Our cutting edge, cloud-native PACS and RIS are designed for imaging centers and high throughput teleradiology practices, while adding our comprehensive suite of partner solutions (such as a radiologist digital cockpit by NewVue, advanced AI reporting tools from RADPAIR, and revenue cycle solutions from Imagine Software). The combination of these cutting edge and customizable solutions work together to drive greater efficiency, speed, and accuracy like never before. Even better – we do this at a cost that makes sense for the smaller group or practice. 

As your organization continues to evolve, consider speaking with our expert consultants at InsiteOne.  We’re here to help you plan and design the right future-proof technology infrastructure to propel your business forward, streamline your operations, and give you the necessary tools to elevate patient care.