Scott Hazelbaker, CRA, MS, remembers a time when leaders in the radiology industry were unapologetically firm and new hires were expected to do as they were told, no matter what.

When CMS finally named a firm start date for its clinical decision support (CDS)/appropriate use criteria (AUC) program last November—financial incentives for appropriately using CDS will kick in Jan. 1, 2018—two key stakeholder groups finally had information they'd been wanting for quite some time. 

Over the last several years, there has been an increased focus throughout the imaging industry on imaging protocol standardization, or more often, the lack thereof.

In the not-too-distant past, picture archiving communication systems, or PACS, were the backbone of every image capture and storage strategy. However, the tide is turning as some healthcare providers gravitate toward vendor-neutral archives (VNAs), in which images and clinical data are stored in a standard format and with a standard interface that make them accessible by systems from disparate vendors.

Not everyone in the medical imaging community is involved with enterprise imaging, but nearly every stakeholder is at least thinking and talking about it. The concept represents an eminently logical next big step in the technology-driven evolution of U.S. healthcare delivery: Imagine a world in which any diagnostic image captured from any image-producing specialty is viewable by any credentialed clinician anywhere and at any time. 

Our University of Utah Health Care system was recently ranked No. 1 in Vizient’s 2016 Quality and Accountability Study Rankings. One critical contribution to this success was an innovative cost/outcome accounting system called Value Driven Outcomes (VDO). Created by Vivian S. Lee, MD, PhD, MBA, senior vice president, dean of the school of medicine and the CEO of the University of Utah Health Care System, VDO captures the true costs of healthcare across the entire enterprise and connects them to patient outcomes, supporting growth through the value equation: Value = (Quality + Service) / Cost.

Consider the average turnaround time (TAT) per patient for the majority of tests you perform daily. TAT matters because it has become one of the most common performance metrics in the imaging industry. But patient-centered care also has become more of a priority. And while serving in your role as a radiology provider, how do you maintain that quick TAT while also providing quality and focusing on the patient? It’s a difficult balance. 

A typical workday for today’s radiologist is probably anywhere from 10 to 12 hours a day, and in most settings, nearly all of those hours are spent reading images at a PACS workstation. This may be a good thing from a healthcare enterprise and business perspective, but what happens to a radiologist’s diagnostic performance after even just eight hours of clinical work? Is it the same as when they started first thing in the morning? Are residents impacted more or less by fatigue given their fluctuating work hours and the pressures of learning their craft?