Radiology-practice consolidation has become more than just a trend: It’s an imperative for future survival, according to Michael Brant-Zawadzki, MD, Ron and Sandi Simon endowed executive medical director chair at the Hoag Neurosciences Institute (Newport Beach, California). “Scale is becoming much more important,” he notes. “Smaller groups are looking for help and are being overtaken by corporate entities like national teleradiology groups—or by larger, independent group practices. Under that model, they can distribute subspecialty services more efficiently and can realize economies of scale.”

Big data, as a term, means different things to different industries and professionals, but loosely defined, it refers to the explosion of information flowing into and out of businesses—including medical practices—over the past few years. Of the world’s data, 90% were created in the past two years alone; IBM estimates that 2.5 quintillion bytes of data are generated every day.

Standardization in radiology can take a dozen different paths, and it is clearly complex—but why is there a need for standardization in the first place? Debra L. Monticciolo, MD, FACR, is vice chair for research at Scott & White Healthcare (Temple, Texas), a nonprofit health system. She is a professor of radiology at the allied Texas A&M Health Science Center College of Medicine and is a subspecialist in mammography. Monticciolo is chair of the ACR® Commission on Quality and Safety. Of course, quality and safety are among the primary reasons that standardization is a talking point for so many who hold stakes in radiology’s future.

Fifteen years ago, when I first started to write about radiology, any attempt to manage or standardize the practice of medicine was met with resistance and derision. Notice that when putting together this issue, we ruled out calling our cover story, “Devising a Cookbook for Radiology.”

Although radiology has employed clinical analytics for more than a decade, the field is in its infancy. Nonetheless, the possibilities are tantalizing—if technological, economic, political, and interoperability hurdles can be cleared.

The ACO, a relatively new concept that met with great skepticism when it appeared in the Patient Protection and Affordable Care Act, now ranks at the top of the conversation-starter list in the radiology community. Imaging providers have debated whether it is necessary for them to engage with these entities, and, if they do, what roles they would play. The current consensus not only is that radiology cannot afford to ignore the ACO model, but also that a strategic approach must be followed if providers are to assume their positions successfully under the ACO umbrella.

Jeff Maze has spent his career attempting to solve the conundrum at the core of business intelligence and analytics: the more data there is, the harder it is for operational leaders to understand and act upon. “Everyone has data. This is the era of big data,” Maze, who is senior manager of business intelligence at Zotec Partners, says. “But data does not mean the same thing as information. The key is taking data and making it timely and actionable, baking your own insight and experience into it, and turning it into wisdom.”

Radiology’s business environment has changed considerably since the heyday of the late 1990s and early 2000s, when the equation for success was comparatively simple, Paul Staveteig, MD, says. “Now, the environment is different,” he explains. “The only way to survive in this marketplace
is to be able to look at things very critically and make decisions very quickly.”