Transitioning to value-based care: What will imaging’s role be?

Preparing for the paradigm shift to value-based care remains a topic of intense focus and discussion while the concept continues to be defined in a meaningful way, according to Cindy Hardin, executive director, Infrastructure Product Management in imaging and workflow solutions at McKesson. “Organizations are working to understand the effects and prepare for the changes,” she says. “The transition to value-based medicine and payment necessitates that organizations communicate, collaborate and convey value and success in delivering quality care. Ensuring that all entities involved in the care episode—insurance companies, patients, referring physicians—participate effectively and efficiently has a direct effect on value.”

Medical imaging has a strong advantage when it comes to communication and efficiency, Hardin observes. It offers near-instant communication with all entities involved in the care continuum: “One of the biggest roles for imaging will be communication—getting the right data to the right place at the right time,” she notes. “When a patient enters a healthcare organization, his or her care team needs to have all of the prior information available in order to make informed decisions. Prior imaging, whether it was done at another organization or in another state, is critical to making sure the right diagnosis is given, and that unnecessary, duplicate exams don’t occur.”

Gateway to value

That’s not to suggest that challenges to reaching this goal don’t exist—some still do, and prime among them is interoperability, Hardin says. “From our perspective as an IT company, we strive to maintain a standards-based solution set so that we’re not asking customers to support custom interfaces and their associated costs,” she says. “Value-based care needs to be efficient. Communicating all of this information using standards is critical.”

Cross-enterprise document sharing is another area of opportunity. “This is still a very green technology in the U.S.,” Hardin says. “Our organizations need to be setting up full registries and repositories for participation in health information exchanges, but because this technology is so new to them, they’re going to be looking to their vendors not only to set up the repositories, but to understand the workflows behind them. It would be a mistake to move forward without the proper analysis of workflows—organizations need to make sure they’re not plugging in new technology without considering all the aspects of what happens in the patient care event.”

Hardin is optimistic, however, that widespread adoption of new technology will not be an obstacle, even among the patient community. “I would no longer consider customer adoption to be a barrier,” she says. “Referring physicians and patients alike have been using this technology in banking, in music, in ordering products on Amazon. The comfort level with sharing information using the web is much higher than it used to be.”

Raising value in radiology

To effectively leverage imaging across the enterprise, organizations are going to have to define what imaging is. “We need a consensus on what constitutes an image,” Hardin says. “Is it any photo taken within that organization’s walls? It’s going to get interesting.”

She also circles back to the subject of the need for standards-based technology, “Many of our customers still have custom interfaces in place for certain systems just within their PACS worlds,” Hardin says. “They’re very unprepared to enter the world of enterprise imaging. The vendor side of the industry needs to get onboard with making sure whatever they install in an organization is standards-based—there are still systems out there today that don’t even support HL-7.”

Unfortunately, already time- and resource-strapped healthcare organizations can only implement these technologies as they can afford them. “Having too many things to do at once dilutes the availability of funds,” she says. “Organizations are struggling with balancing the amount of money available against everything they have to do.”

Finally, Hardin observes that analytics enabled by the implementation of these technologies must be leveraged to support the evolving roles of imaging and the other players in the care continuum. “Improving perception of value is impossible without data,” she says. “The more imaging can demonstrate its worth through analytics, the better off it’s going to be. And, of course, the more information you have, the better you can continuously improve your value.”