In recent years, health-care reform (in all its guises) has spurred providers to investigate new methods and models for delivering services to inpatients and outpatients alike. Some do not affect radiology, but others have major ramifications for the way that imaging is delivered, managed, and paid for, as well as for the integration of radiology

Growth in imaging utilization has led prior authorization (a 1980s health-plan strategy) to be applied to advanced imaging services. RBMs have developed increasingly complex programs to reduce imaging expenses through utilization management, credentialing, channeling to lower-cost providers, and network contracting.

Radiologists are clinicians consultants. We direct clinical management based on our expert interpretation of patient images. Yet, in many cases, radiology reports may not reflect our clinical expertise. Common problems include overuse of vague terminology and omission of the impression. Addressing these flaws can go a long way toward meeting clinicians needs and improving patient care.

Wilson Wong, MD, was there when teleradiology took off, almost 15 years ago. Back then, there was a radiologist shortage, and Wong saw a way to increase the efficiency of coverage and bring some relief to other radiologists who were laboring (as he was) under the constant burden of on-call night work.

Numerous radiology groups are currently discussing arrangements whereby cardiologists and the radiologists would essentially split the responsibilities for reading coronary CT angiography (CCTA) studies. Most commonly, as proposed, the cardiologists would read and generate a signed interpretation report, but limited to the cardiac portion of the