Consistent with the observed trends affecting our national health-care market, the diagnostic-imaging industry has been acutely affected by the forces of consolidation. The number of transactions involving diagnostic-imaging centers has grown consistently over the past five years. Most recently, transactions involving the formation of joint-venture arrangements between health systems and large companies operating multiple freestanding imaging centers have become popular.

The federal meaningful-use program has, at last estimate, garnered the participation of 4,500 radiology professionals, and incentive payments of nearly $1.5 billion are still on the table for eligible diagnostic-imaging professionals. Groups that begin the attestation process by October 3, 2013, of this year can receive up to $39,000 per eligible provider, and as adoption grows among their referring-physician bases, more and more radiology practices are expected to participate as well.

Just when you thought you had a grip on every potential threat to your imaging business, a new one emerges. A June Wall Street Journal article highlights the latest issue being faced by hospitals, in particular: the infection of medical devices, including imaging equipment, by malware. These viruses can expose patient information to outside parties, violating HIPAA regulations; worse, they can compromise patient safety by making equipment malfunction.

Image archiving, communication, and management are no longer radiology-specific concerns, although radiology departments can (and should) play pivotal roles in guiding their organizations’ image management strategies. That was the message delivered by Paul Nagy, PhD, Gary Wendt, MD, MBA, and Paul Chang, MD, in a session at the 2013 meeting of the Society for Imaging Informatics in Medicine (SIIM), held June 6-9 in Grapevine, Texas. All three presenters wear dual hats as radiologists and informaticists, and their experiences transitioning to enterprise archives formed the basis of their talks.

It’s Murphy’s Law as applied to health IT—just as PACS platforms are reaching maturity, image storage needs have exceeded their capabilities, says Alexander Towbin, MD, Neil Johnson Chair of Radiology Informatics at Cincinnati Children’s Hospital, Cincinnati, Ohio. “There’s more and more interest in storing other images outside of radiology,” Towbin says. “Add to that the fact that MU [meaningful use] is encouraging sharing of patient data between two hospitals, including images, and the traditional PACS archive quickly becomes outdated.”

Methodist Le Bonheur Healthcare (MLH), a Memphis, Tennessee-based health care system of eight hospitals, found both its general PACS and cardiology PACS aging past viability at the same time, raising an interesting question: Was the organization prepared to explore an integrated imaging platform and vendor-neutral archive (VNA)? “I wanted our selection committee to consider that since both our cardiology and general PACS were put in place eight years ago, had the marketplace moved on to a higher level of maturity and integration with general and cardiology PACS?” recalls Alastair MacGregor, MB ChB, chief health information officer at MLH.

As the demands placed on hospitals and health systems continue to intensify, the hospital-based radiology group will have to evolve to meet its constituents’ changing needs, according to Chad Calendine, MD, CMO of Optimal Radiology Partners. “It’s a story that is being written as we speak,” he says. “The underlying principle is that radiology groups need to be more aligned with their hospitals, and they have to be conspicuously and actively involved in helping the hospitals reach their goals.”

At Charlotte Orthopedic Hospital (COH) in North Carolina, a change similar to that happening in many hospitals across the country is underway: The facility is becoming more strongly linked to its parent organization, Novant Health. As Charnaye Bosley, RT, manager of radiology at COH, explains, “Where before, each facility kind of stood on its own and practiced what was best for it, now we’re all more deeply connected. We have a large footprint in and outside of the Charlotte community, but patients didn’t realize what a large network we have. Our goal, moving forward, is to be integrated, and part of my role is making that transition as smooth as possible.”