AHRA Virtual Conference: How to define, demonstrate value in radiology

The sessions at the AHRA 2015 Virtual Fall Conference may be prerecorded, but the festivities began on Oct. 16 with a live keynote presentation from Richard Duszak, MD, chief medical officer of the American College of Radiology’s Harvey L. Neiman Health Policy Institute.

Duszak began his presentation by discussing some of the various challenges radiologists face on a daily basis.

“Payers—we all know this very acutely—want to cut all of our fees,” Duszak said. “The radiology benefit managers want to triage us and cut our services. They want to manage our medicine instead of letting those of us in the trenches, who are taking care of the patients, take care of the medicine. We’ve entered an area that some of us have referred to as an all-out war in imaging.”

At center of all of this change, Duszak said, is the increasing importance of value in radiology. And as HHS Secretary Sylvia Mathews Burwell pushes for reimbursements to be further tied to value, it’s up to radiologists to define value for themselves.

“If we don’t define our value in medical imaging, somebody else is going to do it for us,” Duszak said. “It’ll be your CFO, your COO, the new radiology group that replaces your existing radiology group, or the administrator that replaces your job moving forward.”

So how do radiologists define value? And how do then they demonstrate they are providing it? Duszak explained that value can be summarized by one basic equation: value = quality/cost. If you can reduce costs and increase quality, you can provide more value.

However, “increasing quality” does not necessarily mean increasing the quality from your own point of view as a radiologist.

“In the past, I think value in healthcare was largely about us, meaning healthcare professionals, whether we are physicians, medically trained people, or more administrative folks,” Duszak said. “In the future, value is going to be increasingly about patients, it’s going to be increasingly about society.”

A physician-driven system is morphing into a patient-driven system, Duszak said. And those in radiology—and all of medical imaging— must shift away from a “we do things to patients” mentality and into a “we do things for patients” mentality. And they must shift from “doing what works for us” to “doing what works for our patients.”

This adds additional importance to factors such as price, access, and waiting times, because those are areas where the patient perceives quality. And improving the patient’s perception of quality increases value.

“I’m not saying we need to make our lives terrible in the process of doing that,” Duszak said. “We need to redesign the workflow as to what works for them and then, as much as possible, redesign our workflow around that. It’s really the model of service that Amazon, UPS, all the successful companies have done, and the model that unsuccessful companies have not managed to do.”

More information about the AHRA 2015 Virtual Fall Conference is available here, as well as a look at one of the conference’s other presenters.