Ascendian Healthcare Consulting

With reform in the air I continue to hear a word spoken that brings fear into the hearts of those in the Diagnostic Imaging profession: commoditization. This concept is driving Radiology groups, clinics, imaging centers, directors and managers to think about the future and how it will change for this specialty. With as many different perspectives as there are interested parties I wonder if, between the fear-mongers and the Utopians, there is a reasonable approach to consider. Are we doomed to Wal-Mart radiology? Will Nighthawk groups take over the world? Will all of this just be much ado about nothing? I don't think anyone can say with confidence where it will end. But it's fair to say we've created our own problem.

To understand our problem we have to look at our recent history. Several years ago as PACS began sweeping the Radiology and Imaging world several key changes took place that changed how we do business. The first was a change in the way physicians interact with Radiologists. When Diagnostic Imaging was tethered to film, doctors commonly consulted in-person with Radiologists at the beginning of their shift. A quick stop by the reading room to review patient films and discuss was part of preparation. This interaction, formally or casually, was in person and consultative by nature. Once PACS arrived and images were distributed digitally to workstations on every floor of the hospital this one-to-one interaction disappeared. While a distributed image solution created a convenient way to access images and reports anywhere, it unlinked to the personal interaction between physicians and Radiologists.

Vendor Neutral Archives (VNA) are gaining attention in Medical Imaging. VNA's hold promise of true neutrality and most vendors are rushing to bring product to market. This rush, coupled with the immaturity of the technology, has created ambiguity and confusion for early adopters. Many vendors are simply rebranding legacy third party DICOM archives as a VNA solution. Others are providing a full archive solution that accommodates all data types and stores data in native formats. Understanding the difference between the various solutions and archiving methodology is paramount to those who are considering procurement and adoption of a VNA solution.

Jonathan Shoemaker of Ascendian Healthcare Consulting was recently asked to participate in a forum for industry experts to comment on an important technology or service trend impacting hospitals and/or healthcare executives. His response was published in the most recent issue of Executive Insight Magazine.

The President's Council of Advisors on Science and Technology (PCAST) submitted their findings and report several weeks ago. The resulting "buzz" is, as one would expect, mixed. While some celebrate the findings of their review of existing HITECH strategy and architecture, many others are questioning the interests of the participants. The merits of personal interest and whether they influenced the specifics of the report should be debated – somewhere. In the meantime let's look at the crux of the findings: Current efforts and policies within MU do not go far enough to ensure patient data is interoperable beyond the HIE. Bottom line. This is a problem.