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At RSNA, radiologists explore role in HIE initiatives

As information exchange plays a greater role in health care, radiologists are discovering they don't operate in a health IT vacuum. Image sharing can mean more efficient care.

CHICAGO -- Radiologists might sometimes wonder if they’re operating in a health care vacuum. As federal initiatives and health IT lead to greater integration of the care delivery system, and health information exchange (HIE) initiatives means more providers are communicating, though, that sense will change.

The informatics tract at the Radiological Society of North America's RSNA 2011 annual meeting demonstrates just how radiology is already transforming from a specialty practice into a component of the care delivery system that impacts patients and quality in many ways. It's not just about reading images and passing along results.

Indeed, reading an image is just the first step in a health care environment dominated by initiatives such as meaningful use, quality reporting and pay-for-performance. The accrediting organization The Joint Commission is asking radiologists to establish policies for critical test results, and the demands for increased and efficient HIE initiatives have spurred RSNA to develop a standard language for image capture, storage and retrieval. In addition, the society and its members are forming partnerships with standards organizations to build image sharing capabilities among electronic health record (EHR) and personal health record (PHR) platforms.

These drivers have pushed an industry that has been set in its ways to reexamine its practices while creating more efficient and effective care. As Curtis Langlotz, M.D., a professor in the University of Pennsylvania Health System's radiology department, told participants in a session at RSNA, "We've done it pretty much the same way for the last century or so."

The session, dubbed Decoding the Alphabet Soup, focused on a number of programs RSNA is working on to strengthen the position of radiology in health IT. Key among them is RadLex, the standardized lexicon in the works since 2005 that describes how images are captured, indexed and retrieved.

At the end of the day, we are physicians. We are taking care of our patients.

Keith Hentel, radiologist, New York Presbyterian Hospital-Weill Cornell Medical Center

The efforts to create more efficient data exchange and improve communication among radiologists and other providers are not just about compliance, say those physicians who have been at the forefront of these HIE initiatives for RSNA. Quality improvement is about connecting radiology with patient care -- something that can, at times, be lost.

It's the responsibility of the radiologist to provide the best imaging care possible, said Keith Hentel, chief of the division of emergency/musculoskeletal radiology and vice chairman for clinical operations in the department of radiology at New York Presbyterian Hospital-Weill Cornell Medical Center. "At the end of the day, we are physicians. We are taking care of our patients."

Speaking during a session on how IT tools affect clinical quality initiatives, Hentel and fellow radiologist Ramin Khorosani, director of information systems for Brigham and Women's Hospital in Boston, said radiologists are still new to exploring the integration of technology and workflow. But more adoption will be necessary as quality metrics are increasingly tied to reimbursement and performance measurements.

"Quality will either take some money out of your pocket, or put some money back," Khorosani said. "If you can’t measure it, you can’t change it."

Let us know what you think about the story; email Jean DerGurahian, Executive Editor.

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