As imaging leaders work to help their practices move from volume-based care to value-based care, they often find themselves asking the same key questions. How can I improve workflow? How do I ensure everyone has the information they need? Laurie Bergeron is a product manager for workflow solutions at Change Healthcare who develops solutions that help health systems transition to value-based care. She sat down and answered several questions about this important topic.
Do you think workflow solutions are a key component in a successful shift to value-based care?
Laurie Bergeron: Radiologists are being asked to find ways to demonstrate their value beyond reading images. They need to think strategically like MBAs and understand analytics like data scientists so they can align their departmental performance with the overall goals of their enterprise. This alignment isn’t easy—demonstrating value is much more than a simple formula. It encompasses time spent on things like collaborating with referring clinicians, teaching, attending conferences and improving outcomes.
The challenge is that even though radiologists want to collaborate, they’re sometimes limited by the existing systems. As vendors, we need to develop products that facilitate their workflow by bringing data to them where they need it at the point of care. That way, it’s easily incorporated into their workflow where they can use it to improve their diagnoses.
Why isn’t the data already available for clinicians?
LB: In today’s world, there are reams of clinical data, but it’s not always easy to find or access. And ultimately, the data is only useful if the people who need it can use it when they’re caring for patients. Enterprises need to recognize that people in different departments have diverse mentalities, workflows, priorities and training. They need workflow solutions that help them coordinate care across systems so the patient is at the center of the care continuum.
For example, a radiologist who is interpreting a study could find clinical context in many forms. Sometimes seeing the ordering physicians note, correlated pathology results or surgical history, can shed light on the images themselves. The Catch-22 is that these notes are stored in the EMR.
With access to the two primary imaging solutions—the EMR and the PACS—don’t radiologists have everything they need?
LB: From an IT leader’s perspective, that makes sense, since all images and information should reside in one or the other. But for radiologists who use the PACS as their primary system, finding information in an EMR is an unfamiliar process and extracting relevant clinical data can be difficult and time-consuming.
Often, if a radiologist wants to log on to the EMR, he or she performs that task from a separate computer, with a different login. Already, you can see there are two additional steps. Then, the radiologist has to find the patient record and review multiple files or folders for the pertinent information. Basically, they’re searching for a needle in a haystack. Asking them to change their workflow and become familiar with a complicated system will only slow them down. They need tools that help them coordinate care across systems, and alert them to relevant data without digging. That way, they can be as efficient as possible and stay focused on the patient.
What’s the ideal way to connect the EMR and the PACS?
LB: There are two key considerations. Clinically relevant information will help a radiologist every time, so the first step is to integrate the EMR information into a diagnostic reading workflow and make it readily accessible to the radiologist. Ultimately, it comes back to this – good information means better quality interpretations, faster discharge and fewer unnecessary tests. All those things contribute to better patient care.
The second consideration is to give radiologists control over how much information and what kind of information they see. Clinical diagnostic reading has so many nuances; they need flexibility and a configurable GUI that’s tailored to their workflow. The EMR isn’t imaging-centric, so adjusting it to fit a radiologist’s workflow is difficult and costly. They don’t need all the information—just the right information. And a solution that’s designed with imaging domain expertise will always be better than the EMR at distinguishing what’s “right.”
What’s the best possible outcome of connecting the EMR and the PACS?
LB: Quite simply, the more smartly synthesized information you have, the better your interpretation. Radiologists want to provide useful impressions and recommendations and be valuable members of the care team, which is far more likely when they’re considering images along with relevant history. All the clinical data contained in pathology, lab reports and surgical history can impact how a study is interpreted. Not only that, but the additional information gives a radiologist more diagnostic confidence, or helps them make a better recommendation for the next imaging study. It makes the leap from simple data to insight, which has far-reaching implications for patient care.