Providing Value-Based Service to a Sprawling Orthopaedics Practice

Adam C. Zoga; Aleksandr Rozenberg; Alexander R. Vaccaro; Christopher C. Tomlinson

doi:10.1055/s-0038-1673659

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2018; 22(05): 511-521
DOI: 10.1055/s-0038-1673659

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Providing Value-Based Service to a Sprawling Orthopaedics Practice

Adam C. Zoga

¹Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania

²Department of Radiology, Sydney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania

,

Aleksandr Rozenberg

¹Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania

,

Alexander R. Vaccaro

³Rothman Institute (President), Sydney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania

,

Christopher C. Tomlinson

¹Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania

› Author Affiliations

Abstract

Health care in the United States is changing, and diagnostic radiology is attempting to adapt to the new norm. A view of the landscape shows mergers, acquisitions, and radiology practices becoming larger. Musculoskeletal (MSK) radiology is trending toward subspecialization, and orthopaedic surgery practices are demanding quality, convenience, and efficiency in imaging services. In other industries, optimization of operations and strategic deployment of resources are standard, but radiology is not quite there yet. This article details our opportunities in MSK imaging to increase market share through service, added value, and improved operational efficiency.

Keywords

musculoskeletal - orthopaedics - value - subspecialty reads

Full Text

References

References
1 Levin DC, Rao VM. Reducing inappropriate use of diagnostic imaging through the choosing wisely initiative. J Am Coll Radiol 2017; 14 (09) 1245-1252
2 Mayo-Smith WW. Image wisely: reflections of a former co-chair. J Am Coll Radiol 2018; 15 (07) 1055-1057
3 Stern EJ, Everett C, Friedberg EB. , et al. 2017 ACR Annual Meeting open-microphone session: Navigating the landscape of changing practice models: private practice, corporate radiology, and enterprise systems. J Am Coll Radiol 2017; 14 (11) 1384-1387
4 Levin DC, Rao VM. Factors that will determine future utilization trends in diagnostic imaging. J Am Coll Radiol 2016; 13 (08) 904-908
5 Levin DC, Rao VM, Flanders AE, Sundaram B, Colarossi M. Marketing a radiology practice. J Am Coll Radiol 2016; 13 (10) 1260-1266
6 Kemp JL, Mahoney MC, Mathews VP, Wintermark M, Yee J, Brown SD. Patient-centered radiology: where are we, where do we want to be, and how do we get there?. Radiology 2017; 285 (02) 601-608
7 Bhatti ZS, Brown RKJ, Kazerooni EA, Davenport MS. Communicating radiology test results: are our phone calls excessive, just right, or not enough?. Acad Radiol 2018; 25 (03) 365-371
8 Bruno MA, Petscavage-Thomas J, Abuudeh HH. Communicating uncertainty in the radiology report. AJR Am J Roentgenol 2017; 209 (05) 1006-1008
9 Reiner BI, Knight N, Siegel EL. Radiology reporting, past, present, and future: the radiologist's perspective. J Am Coll Radiol 2007; 4 (05) 313-319
10 Reiner B. Radiology report innovation: the antidote to medical imaging commoditization. J Am Coll Radiol 2012; 9 (07) 455-457
11 European Society of Radiology (ESR). ESR paper on structured reporting in radiology. Insights Imaging 2018; 9 (01) 1-7
12 Kovacs MD, Cho MY, Burchett PF, Trambert M. Benefits of integrated RIS/PACS/Reporting due to automatic population of templated reports. Curr Probl Diagn Radiol 2018; S0363-0188(17)30205-0
13 Khorasani R. Optimizing communication of critical test results. J Am Coll Radiol 2009; 6 (10) 721-723
14 Callen JL, Westbrook JI, Georgiou A, Li J. Failure to follow-up test results for ambulatory patients: a systematic review. J Gen Intern Med 2012; 27 (10) 1334-1348
15 Lacson R, O'Connor SD, Andriole KP, Prevedello LM, Khorasani R. Automated critical test result notification system: architecture, design, and assessment of provider satisfaction. AJR Am J Roentgenol 2014; 203 (05) W491-6
16 Pirnejad H, Niazkhani Z, Bal R. Clinical communication in diagnostic imaging studies: mixed-method study of pre- and post-implementation of a hospital information system. Appl Clin Inform 2013; 4 (04) 541-555
17 Tran L, Wadhwa A, Mann E. Implementation of structured radiology reports. J Am Coll Radiol 2016; 13 (03) 296-299
18 Duncan KA, Drinkwater KJ, Dugar N, Howlett DC. ; Royal College of Radiologists' Clinical Radiology Audit Committee. Audit of radiology communication systems for critical, urgent, and unexpected significant findings. Clin Radiol 2016; 71 (03) 265-270
19 Georgiou A, Hordern A, Dimigen M. , et al. Effective notification of important non-urgent radiology results: a qualitative study of challenges and potential solutions. J Med Imaging Radiat Oncol 2014; 58 (03) 291-297
20 Lu MT, Tellis WM, Avrin DE. Providing formal reports for outside imaging and the rate of repeat imaging. AJR Am J Roentgenol 2014; 203 (01) 107-110
21 Zan E, Yousem DM, Carone M, Lewin JS. Second-opinion consultations in neuroradiology. Radiology 2010; 255 (01) 135-141
22 Loughrey GJ, Carrington BM, Anderson H, Dobson MJ, Lo Ying Ping F. The value of specialist oncological radiology review of cross-sectional imaging. Clin Radiol 1999; 54 (03) 149-154 ; discussion 154–155
23 DiPiro PJ, vanSonnenberg E, Tumeh SS, Ros PR. Volume and impact of second-opinion consultations by radiologists at a tertiary care cancer center: data. Acad Radiol 2002; 9 (12) 1430-1433
24 Rozenberg A, Kenneally BE, Abraham JA. , et al. Clinical impact of second-opinion musculoskeletal subspecialty interpretations during a multidisciplinary orthopedic oncology conference. J Am Coll Radiol 2017; 14 (07) 931-936
25 Chalian M, Del Grande F, Thakkar RS, Jalali SF, Chhabra A, Carrino JA. Second-opinion subspecialty consultations in musculoskeletal radiology. AJR Am J Roentgenol 2016; 206 (06) 1217-1221
26 Rozenberg A, Kenneally BE, Abraham JA. , et al. Second opinions in orthopedic oncology imaging: can fellowship training reduce clinically significant discrepancies?. Skeletal Radiol 2018; July 12 ( Epub ahead of print)
27 McGuire CM, MacMahon P, Byrne DP, Kavanagh E, Mulhall KJ. Diagnostic accuracy of magnetic resonance imaging and magnetic resonance arthrography of the hip is dependent on specialist training of the radiologist. Skeletal Radiol 2012; 41 (06) 659-665
28 Lu MT, Hallett TR, Hemingway J, Hughes DR, Hoffmann U, Duszak R. Secondary interpretation of CT examinations: frequency and payment in the medicine fee-for-service population. J Am Coll Radiol 2016; 13 (09) 1096-1101
29 Hunt CH, Wood CP, Diehn FE, Eckel LJ, Schwartz KM, Erickson BJ. Emerging trends in the volume and format of outside examinations submitted for secondary interpretation. AJR Am J Roentgenol 2012; 198 (04) 764-768
30 SanthoshKumar GV, Mahajan A, Desai S, Thakur M. Second opinion by in-house radiologists: present picture and emphasis on standardizing imaging protocol in oncology. Curr Probl Diagn Radiol 2017; 46 (05) 356-359
31 Zimmerman SL, Kim W, Boonn WW. Informatics in radiology: automated structured reporting of imaging findings using the AIM standard and XML. Radiographics 2011; 31 (03) 881-887
32 Flanders AE, Lakhani P. Radiology reporting and communications: a look forward. Neuroimaging Clin N Am 2012; 22 (03) 477-496
33 Forsberg D, Rosipko B, Sunshine JL, Ros PR. State of integration between PACS and other IT systems: a national survey of academic radiology departments. J Am Coll Radiol 2016; 13 (07) 812-818 .e2
34 Ware JB, Jha S, Hoang JK, Baker S, Wruble J. Effective radiology reporting. J Am Coll Radiol 2017; 14 (06) 838-839
35 Maluf M, Rajendran J. Storing radiology images in the reform era: what CFOs need to know. Healthc Financ Manage 2012; 66 (02) 78-82
36 Bialecki B, Park J, Tilkin M. Using object storage technology vs vendor neutral archives for an image data repository infrastructure. J Digit Imaging 2016; 29 (04) 460-465
37 Patel BP, Levin DC, Parker L, Rao VM. The shift in outpatient advanced imaging from private offices to hospital facilities. J Am Coll Radiol 2015; 12 (10) 1042-1047
38 Silva III E, McGinty GB, Hughes DR, Duszak Jr R. Traditional payment models in radiology: historical context for ongoing reform. J Am Coll Radiol 2016; 13 (10) 1171-1175
39 Silva III E, McGinty GB, Hughes DR, Duszak Jr R. Alternative payment models in radiology: the legislative and regulatory roadmap for reform. J Am Coll Radiol 2016; 13 (10) 1176-1181
40 Romano DH. Self-referral of imaging and increased utilization: some practical perspectives on tackling the dilemma. J Am Coll Radiol 2009; 6 (11) 773-779
41 Travis NL, Chananie SJ, Gulick SL. Legitimate lease arrangement or suspect joint venture?. J Am Coll Radiol 2007; 4 (06) 353-355
42 Gyftopoulos S, Harkey P, Hemingway J, Hughes DR, Rosenkrantz AB, Duszak Jr R. Changing musculoskeletal extremity imaging utilization from 1994 through 2013: a Medicare beneficiary perspective. AJR Am J Roentgenol 2017; 209 (05) 1103-1109
43 Kanesa-Thasan RM, Nazarian LN, Parker L, Rao VM, Levin DC. Comparative trends in utilization of MRI and ultrasound to evaluate nonspine joint disease 2003 to 2015. J Am Coll Radiol 2018; 15 (3 Pt A): 402-407
44 Siddiqui IJ, Luz J, Borg-Stein J. , et al. The current state of musculoskeletal ultrasound education in physical medicine and rehabilitation residency programs. PM R 2016; 8 (07) 660-666
45 Finnoff JT, Hall MM, Adams E. , et al; American Medical Society for Sports Medicine. American Medical Society for Sports Medicine position statement: interventional musculoskeletal ultrasound in sports medicine. Clin J Sport Med 2015; 25 (01) 6-22
46 Chiu CH, Chen P, Chen AC. , et al. Shoulder ultrasonography performed by orthopedic surgeons increases efficiency in diagnosis of rotator cuff tears. J Orthop Surg 2017; 12 (01) 63
47 Semaan HB, Bieszczad JE, Obri T. , et al. Incidental extraspinal findings at lumbar spine magnetic resonance imaging: a retrospective study. Spine 2015; 40 (18) 1436-1443
48 Segar AH, Oxon D, Vaccaro AR. Providing value based service to an orthopaedics practice: orthopedics practice needs. Managing the delivery of spine care: what can healthcare learn from the business community? Paper presented at: North American Spine Society 31st Annual Meeting; October 26–29, 2016 ; Boston, MA