The Perfect Radiology Group

The following post was contributed by guest blogger Mark Kristy, MD 

You probably have a fair idea of what your Perfect Radiology Group would look like. Have you ever considered what your CEO’s ideal radiology group would look like? I and fellow members of the ACR’s Specialty Commission on General, Small and Rural Practice wondered as well, and so I asked the administrator of our rural, upper midwest Community Access Hospital for his views. A few weeks after a hallway consult, I had his response. Many of his ideas were surprisingly concordant with my own views, and others were eye opening.

Many of the “Top Ten Elements” were as routine as you might expect. A focus on the patients: Their care, comfort, resulting imaging study and actionable report was foremost, followed by support of the organization, its mission and its administration. Directing the development of the radiology department and guiding its referring medical staff directly without “jousting” figured prominently. This last seems to be an affirmation of using appropriateness criteria and decision support. A genuine desire to teach and maintain up-to-date knowledge and abilities rounded out the areas of expected agreement.

Other points seem to diverge significantly from what many radiologists see as our traditional role. We should help to provide accurate information for coding and billing of claims in a more active and direct way, rather than passively waiting for the relevant clinical information to be given to us. Presumably this would mean facilitating radiologist’s currently limited access to the various hospital and clinic information systems to allow better assessment of patient needs when the clinician is not available, as is often the case. As part of our responsiveness to provider needs, we also need to understand the “why” of the study being ordered to help us deliver a timely, pertinent report. Lastly, we should be willing to work in certain situations regardless of pay and share the costs of providing care to those who lack the resources to pay for expensive studies.

I was pleased and surprised by my CEO’s participation in this exercise. Without having had any exposure to the ACR’s Imaging 3.0™ initiative, he enumerated many of the concepts we as imagers are currently wrestling with. It appears we have common ground for discussion.

CT Lung Cancer Screening: What’s Next?

The following post was contributed by Geraldine B. McGinty, MD, MBA, FACR 

When an email from CMS pinged my inbox at 4 o’clock this past Monday I read with relief of Medicare’s decision that the evidence supports coverage of low-dose CT screening for lung cancer. I was delighted to see included in the Agency’s specifications for how they would like to see the program structured the rigorous quality elements that ACR had presented to them. I firmly believe that the team-based approach that ACR took in building a robust stakeholder coalition and our focus on “doing it right” was instrumental in helping the Medicare staff to make their decision in favor of coverage. But I’m not relieved because of the countless hours that we’ve all spent on this effort and because we “won.” No, I’m relieved because in just this past couple of weeks I have supported friends through the heartbreaking realization that they are going to lose a parent to lung cancer. I’ll be glad not to have as many of those conversations as we work to diagnose lung cancer earlier and save lives that would otherwise be lost to this terrible disease.

Is the decision perfect? As always, there are definitely areas on which we’ll comment. Cutting off coverage at 74 will leave many at-risk seniors without coverage for example and we have some concerns about the burden and cost associated with adding a visit as a precursor to every follow up CT, but we’re confident we can work with CMS to bring this important new program to fruition. Many of you will have questions on payment and rest assured our teams at ACR are scenario planning as I write to figure out the best solution for which to advocate on order to provide access for our patients and fair reimbursement for those who provide this lifesaving service. Stay tuned to the ACR website for more updates as CT lung cancer screening progresses.

November 8: International Day of Radiology

The following post was contributed by Howard B. Fleishon, MD, MMM, FACR

This Saturday, Nov. 8 marks the third International Day of Radiology. 119 years ago, Wilhelm Röntgen discovered X-rays. That historic event marked the beginning of the long journey, which led to the birth of the profession of radiology.

This year’s theme is brain imaging. Neuroimaging has become integral to the diagnosis and treatment of brain diseases and injuries. Physicians worldwide use imaging to detect neuropathology and monitor responses to surgery or therapies. Modern neurosciences rely on the work began by Röntgen to deliver care and develop innovations.

Radiation therapy plays an important role in the treatment of some brain diseases, such as cancer. Today, 50 percent of brain cancer patients undergo radiation therapy are being treated with the goal of curing cancer.

Traumatic brain injuries are increasingly recognized as an important predictor of future cognitive impairment. It is estimated that 1.6 million to 3.8 million concussions occur each year in the U.S. In response to this challenge, the ACR formed the Head Injury Institute (HII) in 2013. The mission of the ACR HII is to bring together head injury specialists to advance research, prevention and treatment of head injuries through the application of diagnostic imaging.

International Day of Radiology is jointly sponsored by the American College of Radiology, the Radiological Society of North America and the European Society of Radiology. Join us in your department and practices by celebrating Röntgen’s discovery and promoting the impact medical imaging has made for so many of our patients. Join us.