RSNA 2013 was a busy time for the National Decision Support Company. Although the official theme of the show was “The Power of Partnership”, the unofficial theme of the show was clearly “Value-based Radiology”.
We had over 400 visitors to our booth, and tons of walk-in traffic. Our visitors spanned the gamut of the RSNA attendance, from clinical leadership in major healthcare providers to radiologist leadership from nearly every practice setting. This level of traffic yielded some incredible dialog and perspective about how the imaging community is embracing partnership and delivering on the promise of value based radiology.
National Decision Support Company (NDSC) is the American College of Radiology’s commercial partner for delivering the integration ready, electronically consumable version of the ACR’s Appropriateness Criteria ® under the name ACR Select. The launch of ACR Select was part of the ACR’s Imaging 3.0™ initiative, which provides a framework and set of technology tools to enable radiologists to transform the delivery of their services in the new value driven healthcare economy. At its core, Imaging 3.0 ™ is simple:
- Ensure the value of proper imaging
- Ensure the right test, at the right time, is properly performed and interpreted
- Create a platform and tools to promote the value of imaging
- Confirm the role of the radiologist as a valued, cognitive, consultative member of the care delivery team.
Many of our visitors became aware of ACR Select through co-marketing between the ACR and NDSC related to the Imaging 3.0 ™ initiative. They wanted to know how the simple step of integration of the appropriateness criteria at the point of order could improve radiology services. It’s a simple step, and we had a simple answer:
Implementing ACRSelect at the point of order is the start of a powerful transformation process for delivering better care through imaging and enhancing the value proposition for Radiology services.
From the perspective of Radiology, ACR Select is an opportunity for Radiology to drive towards more appropriate utilization of valuable imaging resources by having its criteria guide the ordering physician. Where required, the platform enables direct consultation between the ordering physician and the radiologist.
By linking a structured reason for exam (vs. the typical free text), and tracking the appropriateness of an imaging procedure together with the entire patient record is an opportunity to quantitatively define what we’ve known all along:
Inappropriate use of Imaging is wasteful and the best imaging means better care.
This launched a range of interesting dialogs and perspectives about value based care and we thought we’d share some with you.
Several Radiologists initially pushed back on the idea of being available to consult on the best imaging procedures when ACR Select returns an indeterminate score, while others thought that the consult should be yet another paid transaction.
Part of our message at the show was to help radiologists understand how much money is being spent on imaging prior authorization in markets where payers already have adopted Radiology Benefits Managers (RBMs). In markets that have not, we discussed how providing this consultative service is a way to re-position the radiology practice directly in the value chain. When Radiology drives substantial savings for the healthcare provider, and embraces risk, a bigger slice of the imaging pie becomes available.
This is at the crux of radiology’s transformation from a volume-based service towards driving value-based care, and ACR Select is the cornerstone
Now several Radiology practices are in the planning stages of embracing the consultative role in recognition of the opportunity to position imaging in the patient care cycle, engage the ordering physician and drive value-based care. Positioning their provider relationships and the order entry workflows to guide the ordering physician to consult with a Radiologist when needed, and using the ACR Select platform to manage and track the interaction.
Not only did we provide guidance, consultation and education to the market. We learned a few things of our own from radiologists already living the Imaging 3.0 philosophy.
Most notable was the interaction we had with a radiologist, who was presented with an ED ordering scenario that was a clear case of inappropriate imaging driven by the need to practice what can only be called defensive medicine. The radiologist offered to include a comment in the medical record that it was his professional opinion that the exam was not indicated. The ordering physician was more than grateful. The radiologist had added value. As such, this is now standard practice in his facility’s ED. When this same physician learned that ACR Select is the ACR’s Appropriateness Criteria ®, he now had a defensible national standard to inform decisions, and a way to help provide this same value across the board by introducing ACR Select to the ordering physicians and the healthcare provider. The rest was easy.
Like we said, RSNA a busy conference. Our participation in RSNA 2013 only reinforced that we’re on the right track, and, with the support of the ACR membership we have solidified our role in driving value-based imaging. We value the partnerships we are creating with the healthcare community. More importantly, it is incredibly fulfilling to be providing a platform that can reinforce the partnership between radiology and the healthcare provider.