Only a few years ago, many people were first learning about the cloud concept. It was a buzzword popping up in news stories and “what’s new” technology features. It has taken a while for the cloud to sink in as a platform that makes our mobile devices endpoints for a universe of information including email, financial, and healthcare data—and entertainment media that drives the majority of current utilization—so that people don’t have to store all those gigabytes and carry them around in person to get done what they need.
But, we get it now. We get access from any machine, anytime, anywhere to securely reach that crucial information that drives our personal and professional lives forward. Yet healthcare data lags behind virtually all other data types when it comes to portability and delivery through the cloud. While health IT experts and policymakers have been working tirelessly for years to bring our data systems up to par with others, more work needs to be done. Cross-vendor and cross-industry partnerships remain vital to improving patient care as health IT vendors follow the path blazed by predecessors at the Office of the National Coordinator of Health IT.
Imaging, however brings its own set of unique challenges to the healthcare solution that eventually will be an interoperable replacement for the discrete silos that make up today’s health IT landscape. Before data can flow freely among EHRs, imaging systems, devices, patients, and providers in different locations, there are substantial technical and business model issues that need to be solved.
Forward-thinking providers, academic medical centers, integrated delivery networks, and health plans now are realizing that interoperability is not just a patient care and quality benefit, but a competitive advantage that attracts patients to their
Healthcare providers have historically been set up for volume-based care: more scans, more volume, and more capacity. Now, payers, patient advocates, and industry organizations such as the American College of Radiology are calling for a change to something they call “value-based imaging,” a facet of Imaging 3.0. It’s how economic forces in U.S. healthcare are incentivizing better patient outcomes, reduced costs, improved safety, and reduced radiation exposure—all made possible through health imaging interoperability.
Until now, health data interoperability had few incentives to drive it forward. In a recent CHIME survey (sponsored by lifeIMAGE) of 100 U.S. health IT leaders, it’s clear that both public and private payers are beginning to reward organizations that have interoperable systems with value-based contracts and are denying claims when an imaging scan looks like it was unneeded or a duplicate in the claims documentation.
Moreover, interoperability is only going to get more financial backing. New MACRA rules from the Centers for Medicare and Medicaid Services that compute care-quality scores include compliance choices for providers to search for previous CT studies and to make CT scans available to patients and providers for 12 months.
The cloud is a big part of the answer
So, how do we turn around the ship of volume-based care with technology? Start by enterprising imaging strategies that properly utilize the cloud and promote the liquidity of imaging information throughout the enterprise, and then by extending that data to physicians and institutions outside the firewall that perform consults, second opinions, analytics, population health, telehealth, and the universe of other healthcare activities.
Interoperability improves patient care by avoiding duplicate, unnecessary tests and exposing patients to unneeded radiation. That is how Imaging 3.0 has the potential to create value, patient safety, patient satisfaction, and better care quality.
And, it’s not only the radiology department that needs imaging interoperability. By our count, more than 50 medical specialties are heavy users of imaging. In a recent usage audit—comprising health systems of all sizes, skewed to large academic medical centers—broken down by specialty, radiology ranks fourth, behind neurology, surgery, and internal medicine. This might be surprising because when many healthcare professionals think of clinical imaging, they assume it is radiology.
Since the 1990s, picture archiving and communications systems and vendor-neutral archives have been the repositories for most imaging. But those technologies are starting to show their age, especially in an era where health systems have accumulated disparate systems through mergers and acquisitions and the purchase of local independent practices. Health systems desperately need more flexibility and agility.
Inside the firewall, enterprise viewers can help all clinicians who use imaging to get their work done. But what happens outside of the firewall? This is where interoperability is essential to create true value and enables patients to do the following:
- get CT or MRI scans at a standalone imaging center, seek second opinions,
- send hospital images to primary care or specialist provider,
- secure referrals at specialists outside their usual network, and in the future, demand better
- access to their personal health information.
A key to true interoperability
This is why in the MACRA rule, we believe, there was very specific wording of one quality measure. It requires practices to search for Digital Imaging and Communications in Medicine to format images of prior patient CT imaging studies at non affiliated external healthcare facilities or entities within the past 12 months and are available through a secure, authorized, media free, shared archive prior to an imaging study being performed.
The wording, of course, is ambiguous. It accommodates evolving technology over the life of the MACRA program. But it’s clear to us the most obvious way to make that archive shareable with non affiliated entities is via a secure cloud. Even if this year brings changes to health IT incentive programs, private payers will still need such interoperability to sustain quality- and value-based reimbursement models.
Do you have a strategy in place that will help your clinicians work more efficiently with state-of-the-art tools within your firewall and a secure cloud to exchange images with non affiliated provider—a new requirement for a claims process coming soon to your finance department? Healthcare organizations that don’t have image-inclusive interoperability expansions in place should be drawing one up now.
Payers are expecting it, and patients are counting on you to make their care safer, more cost-efficient, and convenient—because if you don’t do it, they will have the power and information to find care givers who will.