What changes do you see in radiology as ACOs unfold?
[Joe Moore] More confusion, turmoil and disruption. Imaging has a target on its back due to the increased utilization and skyrocketing costs. The sad part of that is radiologists are not the cause but will be the most affected. Between specialists making the most of the Stark in-office exemption and ER doctors practicing defensive medicine, they are killing a vital industry.
In the government’s usual fashion, they avoid dealing directly with the cause and instead have chosen the route of making imaging less profitable. This will have little impact on those responsible since they will just order more tests and imaging is not their core line of business. Radiologists on the other hand get all their revenue from imaging and will be affected significantly.
So, getting back to the original question of how ACOs will impact radiology, I think they will be incented to continue the assault on imaging and potentially destroy a once vibrant and vital industry.
What do you believe the radiology IT priorities are for 2012?
[Joe Moore] Position for survival. In my opinion the writing is on the wall for radiology and we can already see the changing landscape taking shape.
Radiology needs to be more flexible and embrace a service model that makes them more vital. The industry of radiology is partly to blame for current trends toward outsourcing imaging to large, national groups. Radiology is now a 24x7x365 service and hospital administrators are increasingly demanding more from their radiologists.
The trend to date has been to give away the night-time business as the volume of work isn’t enough to justify the cost of having a radiologist working a night shift. Groups around the country continue to be surprised when their long-time partnerships with hospitals and systems end abruptly as they hand the work over to national provider groups. IT can prepare the practice for the transition to a more complete service model by ensuring their systems can support multiple organizations, run on networks designed to distribute the workload across the enterprise, interoperate and integrate with many systems, and adapt to the changing landscape.
What technologies are exciting for radiology right now?
[Joe Moore] Radiology has always embraced technology and has never needed an artificial incentive to take advantage of the latest technology, that’s why I love working in the field of radiology IT. The most exciting technology today, for my money, is cloud services and virtualization. These technologies support the priorities I mention above and are critical to our operation.
We’ve made a fair amount of progress here at RCI virtualizing the data center and many of our desktops. We have what I think most would consider our own internal cloud. I look forward to the day when we can virtualize our PACS workstations, which will provide great flexibility, customization, fault tolerance and efficiency. External cloud services can best be utilized to offload common IT tasks such as spam, virus and web filtering, backup and disaster recovery, web hosting, etc., thus allowing the internal IT to focus on technology that is unique to radiology.
I don’t see us going fully to external cloud services any time soon but certainly a hybrid model of both internal and external cloud services is the way to go, in my opinion. If I were starting a business from scratch I might look at that differently and consider a complete operation running in the external cloud.
Healthcare integration and interoperability have always been a strategic initiative for RCI. What new initiatives are you undertaking? Any health information exchange (HIE) involvement?
[Joe Moore] RCI is involved in a couple of HIE initiatives at the state and local level. We feel that to continue to add more value to our service it is critical that we participate in the efforts to make our information available to all who need it, when they need it, in an appropriately secure fashion. I think we’ll have to support numerous avenues of integration and interoperability whether it be with PHRs, EHRs, HIEs, or whatever else comes down the pike. This really leads back to our priority of being flexible and prepared for the known and unknown changes coming at us.
There are many new professionals joining the health IT profession. What advice would you give them?
[Joe Moore] Run away and don’t look back! Just kidding. The transition that health care is currently undertaking is immense and there is great opportunity with the challenges facing HIT today.
I would say the number one thing to focus on is the core business or core service you are supporting. Make sure you understand the point of view of the clinician.
This transformation isn’t similar to other industries. I laugh when people try to compare banking to healthcare and relate banking’s successful use of new technology to health care’s failure to use the same. You have to remember that clinicians work impacts people’s lives. While finances are important, no one ever died as a direct result of a banking foul up. When you put a new application or process in the hands of a clinician, understand many of them are horrified at the thought.
IT should be there to get them over their anxiety and provide the expertise to train them to use the new system to its fullest extent. Don’t take criticism personal and never assume you know what a clinician wants; most of the time the opposite is true.
Realize your success relies on their successful use of the applications and services you provide and support. If the end users are miserable, you’re going to be miserable. Take pride in being a service provider. Too many in HIT see themselves at some higher level of intelligence just because they work in a field that is a mystery to many. So what, at the end of the day what really matters is the core business and how well the technology supports that. You can have the greatest LAN, SAN or whatever AN you want, but if it doesn’t work for the end user and support the core business, it’s useless.
Don’t think of the technology as the most important thing. Think about the end result, take pride in being a service provider and have some patience and respect for your end users.