Today's predominant focus on achieving better outcomes with greater efficiency is redefining traditional priorities for hospital executives. Government regulations and market forces are pushing healthcare organizations to alter their approach to care. Part of that shift includes making patients more active participants — rather than passive recipients — in their care.
In many instances, this is accompanied by a growing patient demand for health information, which hospital executives can use as a catalyst for greater operational efficiency. For example, although medical images are not always top of mind in the C-suite, technological advances are making it an ideal time to re-examine the significant impact medical images can have on key business and regulatory goals. A holistic medical imaging strategy is one way to streamline care processes and take costs out of the system, while also improving patient satisfaction and strengthening market presence among consumers.
Patients as consumers
Perhaps the most significant change in healthcare today is redefining patients as "consumers" rather than "recipients" of care. Wellness measures are replacing reactive medical care as the new healthcare norm. While some patients may be more on-board with the concept than others, all patients are being encouraged to take more proactive control of their care.
For hospitals, this means accommodating patients who, for the first time, are beginning to demand better access to their health records — including medical images. The average patient today is keenly aware that he or she has more control over banking, credit, insurance and legal data than potentially life-saving medical information. As a result, patients, whether they realize it or not, are starting to work in tandem with the underlying tenants of meaningful use and other regulations to share data and images to better coordinate care.
Images — whether X-rays, ultrasounds, CT scans, MRIs or any other modality — often are critical to helping providers piece together a patient's history, assessment and care plan. A heart patient discharged from the hospital, for instance, may be urged by a nurse navigator to follow up with his or her primary care physician in order to mitigate the risk of readmission. The scan that revealed exactly what caused the hospital admission in the first place could prove invaluable as the primary care physician tries to develop an effective long-term care plan. Patients understand this fact and expect hospitals to be able to share images with the same ease with which banks share financial information.
Indeed, medical images can be particularly powerful components of care coordination for hospitals being forced to rethink how to make interoperability a functional reality. In this new era of value-based healthcare, hospitals that make it easiest for patients and their physicians to access their images can expect to see benefits in the form of garnering MU incentives, lowering readmission rates and bolstering patient satisfaction — with subsequent impact on HCAHPS scores. This can be accomplished, at least in part, by taking two steps:
1. Storing all medical images in a central enterprise imaging archive. Instead of storing images departmentally throughout the hospital, a central archive provides availability and single-point access to every image regardless of modality.
2. Connecting the central imaging archive to the electronic health record and/or health information exchange to improve interoperability with community physicians and others outside the hospital's four walls.
Collaboration through images
As technology advances, the detail, depth and refinement of the images produced make them even more valuable as a diagnostic resource. However, as the electronic file size of images grows, it also makes them more difficult and expensive for hospitals to store, maintain and share electronically. An imaging strategy that comprises a universal image viewer, a centralized enterprise-wide vendor-neutral archive and an efficient image-sharing network allows hospitals to not only minimize imaging storage and maintenance costs but also to satisfy the access requirements of patients and their community providers.
• Universal viewer. With a universal viewer, all providers within an enterprise can access images — and without the need to replace existing infrastructure or download additional software, apps or scripts. A zero-download digital imaging and communications in medicine viewer that can be accessed through an embedded link or a stand-alone portal allows physicians to see images on any browser-based electronic device. This improves access to images while also lowering IT costs.
• Enterprise VNA. A centralized VNA gives any authorized party within the healthcare enterprise access to archived information. Essentially, it acts as a single storage bin that allows hospitals to manage images for multiple specialties or sites, with standardization so that images can be displayed on any DICOM viewer within the enterprise. This gives providers a single-point of access to every patient image, which can save time, improve treatment and reduce the need for duplicate images.
• Connected network. Implementing an image-sharing network is the final piece of an imaging strategy that allows hospitals to work more collaboratively with referring community physicians. The ability for physicians to place orders for images and then view those images electronically facilitates collaborative care across the continuum.
From a business perspective, one of the biggest benefits of being able to offer this type of connectivity to community physicians is the chance to develop "stickiness" with those referring physicians in a market of increasing competition and consolidation. Image access via the EHR is also a key part of meeting MU stage 2 (and ultimately stage 3) requirements. Yet with all of these hospital-centric bottom-line advantages, it's important not to overlook the additional benefits solutions like these bring to patient care, patient satisfaction and patient retention.
Patient satisfaction and retention
Patients want physicians who can, and do, work together. Through a holistic imaging strategy, patients and providers alike can be freed from the traditional constraints of geography. Sharing information and images across disciplines gives patients confidence that their entire team of physicians —cardiologists, dermatologists, endocrinologists, orthopedists, etc.— are collaborating to provide high-quality care no matter where they happen to be located.
Take the scenario of a man on vacation in Florida who injures his leg. With image-sharing technology, the emergency department staff can quickly access all of the details of his recent knee replacement — including his orthopedist's notes, X-rays and the patient's history of high blood pressure. The patient gets the appropriate course of treatment, and because his physicians are all partnered through the common image archive, the patient feels confident, comfortable and satisfied with the treatment process.
For hospitals, an imaging strategy that enhances patient satisfaction makes bottom-line business sense. Higher patient satisfaction can increase reimbursement through factors such as HCAHPS scores, attract new patients through visibility on comparison websites such as RateHospitals.com, and help retain existing patients. After all, satisfied patients are unlikely to seek care elsewhere.
The future state of healthcare and imaging
Whenever a process is made more efficient, costs decline. In the case of patient and provider access to images, the costs decrease in every part of the system. The patient, now a consumer, saves money by shopping for the lowest insurance rate and participating in wellness programs that keep them healthy and out of the physicians’ office.
The current method of saving images departmentally using multiple independent storage solutions in multiple independent locations is expensive and inefficient. With a universal viewer, enterprise archive and connected network, however, costs can be taken out of the system while still improving the patient experience. A health system might not need a pediatric radiologist at every hospital, for example, if all images and data can be accessed by a single pediatric radiologist beyond the traditional "four walls" of each hospital.
Although traditionally "out-of-sight, out-of-mind" for hospital executives, image sharing technology now offers a chance to not only improve operational efficiency but to do so in a way that deepens relationships with referring providers, strengthens ties with existing patients and appeals to new patients.
There is no question that the move toward patient access to medical images is affecting the fundamental nature of the healthcare system. Change is inevitable, and it's happening fast. It is crucial that hospitals embrace these changes as the opportunities they are — ways to increase efficiency, lower costs, satisfy patients and improve the quality of patient care.
Justin Dearborn is the CEO of Merge Healthcare, a leading provider of clinical systems and innovations that seek to transform healthcare. Mr. Dearborn has served as president of Merge Healthcare since November 2010, and as CEO since June 2008.
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