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Radiology might be one of the oldest -- and it's definitely the biggest -- of American medical specialties, but at the upcoming 100th Radiological Society of North America (RSNA) annual meeting in Chicago, its practitioners are incorporating the newest health data tools and concepts to support its cutting-edge diagnostic technologies. That and also trying to keep up with the rest of U.S. healthcare when it comes to the federal meaningful use EHR incentive program.
Rasu Shrestha, M.D., chief innovation officer at University of Pittsburgh Medical Center, is one of the leading thinkers in health IT and chairman of the radiology informatics committee of the scientific program at RSNA. After helping cull thousands of peer-reviewed papers submitted to RSNA 2014 for presentation at the show, Shrestha outlined for SearchHealthIT the hottest radiology IT topics this year.
Among those hot topics, for the fifth straight year, was meaningful use. Shrestha and David Hirschorn, M.D., director of radiology informatics at Staten Island University Hospital and former chairman of the radiology informatics committee of the RSNA scientific program, offered insights into the notable role that meaningful use of EHRs still plays in radiology.
Top five things to watch at RSNA 2014
- Value: "We're in an environment where radiology as a specialty is moving from volume to value," Shrestha said. "Value-based imaging is understanding that doing as many studies as possible is actually hurting care."
- Analytics: "Better decision support means better quality, better outcomes and lower costs," Shrestha said of new healthcare priorities driven by health data analytics tools. Radiology increasingly is focusing on clinical quality metrics and the kind of evidence-based decision making that accountable care organizations, or ACOs, are built around, he said.
- Mobility: "The value aspect of mobile is not just for doctors, but for patients as well," said Hirschorn, who is moderating a conference panel on mobile devices in radiology informatics. He added that mobile-accessible images can allow patients to share their medical images with their doctors.
- Quality: "How do you ensure the quality of the patient record, and that you're doing the appropriate studies for the appropriate reasons at the appropriate times?" Shrestha said.
- Image processing and analysis
Also trending, Shrestha said, is image sharing, not only via PACS [picture archive and communications systems] and VNAs [vendor neutral archives] within healthcare organizations, but also across cloud-based systems such as Nuance Communications Inc.'s PowerShare network.
Radiology intersects with meaningful use
As for meaningful use, despite its uncertain status in the current political climate, the federal government's EHR incentive program is still effecting changes in radiology, both Shrestha and Hirschorn said.
One transformation affects radiology's own traditional EHR -- radiology information systems (RIS), Hirschorn pointed out.
"There's no question that the adoption of meaningful use is pulling RIS out of radiology and into the EHR," Hirschorn said. That means that EHR vendors are having little trouble incorporating radiology events and workflow into their software systems, he said.
Merging hugely data-intensive radiology images with physicians' everyday EHR screens is much more difficult, and apparently not a task many mainstream EHR companies have wanted to take on up to now.
In the meantime, however, meaningful use's expected emphasis on quality measures in stage 3 in 2015, and possibly beyond, will likely loop radiologists more and more into the entire continuum of care instead of leaving them relatively isolated and seen as mere image producers, according to Hirschorn.
"We do care a lot about decision support," the Staten Island radiology informatics expert said. "[Generalists] are taking care of the patients' bruises, their cancers. Our job is to decide: What's the best test to order? That's the part radiologists care about. That's where meaningful use is driving this."
Shrestha concurred, saying meaningful use stage 2 and stage 3 both emphasize quality in radiology. In both stages, "you have to do quality for meaningful use dollars," he said.
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