Article – CPOE use can reduce unneeded CT scans

dondennison Radiology , , ,

Not a mind-blowing revelation, but when doctors are told that the information they want already exists, they don’t order more tests (usually).

And while the results of the study summarized in this article reflect only a small decrease in new CT exams being ordered (“physicians canceled orders after receiving the alerts about 6 percent of the time, making for a net cancellation of 1.7 percent of studies. In a control group, physicians canceled only .9 percent of alerts.”), every bit counts.

And it reduces the radiation the patient receives, as well as helps keep the Radiology schedule free for really important exams.

A goal to simply reduce the number of exams performed is misguided. This blog post summarizes a proposed model to help separate the necessary from unnecessary exams.

Article – The 8 RIS innovations you need now

dondennison Healthcare IT , , , ,

Here is a summary (note: may need to register with site to access) of some RIS (Radiology Information System) innovations that providers should be looking for.

Sneak peek…

  1. Digital dashboards
  2. Electronic medical record aggregation
  3. Clinical decision support
  4. Critical results reporting
  5. Customer service
  6. Technologist feedback
  7. Peer review
  8. Data mining, surveillance, and outcomes

I am working on an article on how (and why) RIS and PACS will be deconstructed and will not exist (as we know them today) in the future. Stay tuned for that.

Article – There Are Only Four Jobs in the Whole World – Are You in the Right One?

dondennison Inspiration

Which Are You?

An article worth reading (if you didn’t already by going on LinkedIn).

I would like to think I am equal parts Thinker and Builder, with a little bit of Improver (when it is called for). I get bored being only a Producer.

Article – EHR part of MaineHealth’s financial woes

dondennison Financials ,

This article describes a “perfect storm” of factors that lead to the health system’s financial loss…

…”the operating loss is due to declines in inpatient and outpatient volumes because of the hospital’s efforts to reduce readmissions and infections; “unintended financial consequences” due to the roll out of the health system’s Epic electronic health record and problems associated with being unable to accurately charge for services provided; an increase in free care and bad debt cases; and continued declining reimbursement from Medicare and MaineCare, the state’s Medicaid program”

Article – Report Offers System to Separate Useful and Wasteful Imaging

dondennison Radiology ,

In this article, the authors describe a simple classification system for defining different types of additional imaging exams. Too often, additional imaging is deemed wasteful, so having a model to separate the necessary from unnecessary is a good idea.

The model excerpted from the article…

  • A supplemental image — many of which are medically necessary — would occur during the same clinical encounter but utilize a different modality, such as a non-contrast CT scan and a renal ultrasound to identify kidney stones.
  • Duplicative images involve the same modality during the same or subsequent clinical session. These images are taken for a variety of reasons, including the unavailability of previous scans or a change in the patient’s condition.
  • Follow-up imaging can involve the same or different modalities during later clinical meetings, such as repeated imaging in cancer patients to verify there’s been no relapse of disease.
  • Unrelated imaging — scanning of the same body area with any modality — is often an unforeseen event. For example, in its paper, HPI discussed unrelated imaging in a woman who had CT screenings for breast cancer staging two weeks prior to a car accident that prompted identical scans.

Article – ONC chief: Regulation fuels innovation

dondennison Policy , ,

This article debates the impact regulation has on innovation.

My 2 cents: Regulation provides consumer protection; standards provide access to data, which often leads to innovation.

More thoughts and notes…

  • Mobile “apps” seem to always be cited as examples of innovation, but I believe  the Web services (based on REST) that enable mobile and Web access are the key to innovation—the client will change over time (browser, smartphone, downloaded app, HTML5 app, tablet, etc.), but a secure, flexible and reliable API makes the change less painful. Thankfully, standards bodies (DICOM, HL7) are focusing efforts in this area. The Web services and the clients don’t need to be from the same vendor, or even use the same technology—that is the beauty of REST.
  • I like how people that issue regulations make statements about the benefits of these rules, such as driving innovation (they claim). Shouldn’t we ask the people that have to operate (and attempt to innovate) within the interpretation of these guidelines? I intentionally used the word “interpretation”, as different regulatory  professionals seem to have different opinions on what burden of process needs to be met for medical devices.
  • The FDA’s eagerly-anticipated guidance on mobile apps and devices “should be out by October.”

Q&A – 10 Questions with Tessa Cook, MD, PhD

dondennison Radiology ,

Check this out. I know Tessa from my work on the SIIM board. I greatly respect her positive attitude. It’s one of things that makes SIIM great.

Blog – Bundled Payments Could Short Change Radiology

dondennison Policy ,

In this blog post / article, Dr. Douglas G. Burnette Jr. expresses his concerns over Radiology reimbursement cuts, and bundled payment in particular. Provides a good perspective of how those affected by policy are feeling these days.

Article – Survey finds growth in use of department dashboards

dondennison Radiology

This article has some stats from a survey on the use of dashboards in Radiology.

Some key stats…

  • 62% of the respondents used dashboards for managing accessibility, financial, and productivity indicators; of these…
    • 50% started using dashboards < 2 years ago
    • 10% had used dashboards for > 10 years
  • 73% of departments used their RIS (only) as the source of data, 6% from their PACS (only), and the remainder from both the RIS and PACS
  • 35% viewed productivity metrics more than once a month, only 8% viewed the information daily
  • Most commonly viewed access metrics: department turnaround time and patient backlog were the most frequently used
    • 50% regularly reviewed transcription times
    • 60% were interested in the time from preliminary findings to report finalization and sign-off
  • Most commonly viewed financial metrics: reporting revenue, actual expenses compared to budgeted expenses, and the number of days that billable exams were in accounts receivable
  • Most commonly viewed productivity metrics: total examination volume, volume per modality, and productivity performance by radiologists and technologists

Article – Pragmatic Marketing – “The X Factors”

dondennison Product Management

I am a big fan of Pragmatic Marketing. If you are a Product Manager (or want to be one), check out this write up (scroll down in the PDF to find the actual article) on the attributes of successful people in this dynamic role.