Category Archives: Radiology Innovation and Quality

Disruptive innovation! Six-sigma! DMAIC! Sustainable growth rate!  These are words people throw around, but it’s the idea that counts, not just the acronyms.

The [machine learning] race is on – Don Dennison

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The Paradox of Standardizing Broad Data

Last October, my team started working on a project to bridge the communication gaps between inpatient general medicine and radiology.  Despite having done a full year of internship before starting residency, we quickly realized that as radiologists we knew very little about healthcare is delivered on the wards.  Understanding how well the imaging workflow runs from ordering to reporting, identifying possible delays by systematically analyzing patient data seemed straightforward.

Hypothesized imaging workflow for admitted medicine patients. Source: post author

A 2-hour meeting, eight weeks of delay, and several email exchanges later, we now rely mostly on manual data collection. This blog post is about what happened. Continue reading

Think Outside the (View) Box

Twenty years ago, medicine and surgery rounds used to start in the reading room.  Sitting in a dark room with a viewbox and an alternator, a senior radiologist greeted visiting clinical teams every day and reviewed their patients’ films.

With the advent of digitization and picture archive and communication system (PACS), the last 20 years saw a rapid evolution of radiology.  We read studies faster than ever, and radiology workflow focused extensively on the interpretation of images and the associated diagnostic report.

Recently, there has been a revival patient-centered care and communication.  Communication is the new radiology workflow.

I had the pleasure of writing about the importance of communication in radiology in a previous post. Just this month, a group at Beth Israel Deaconess Medical Center writes in American Journal of Roentgenology that despite our focus on critical value communication, the bulk (52%) of errors in radiology communication actually occur outside of results.

While most communication errors did not cause patient harm, 37.9% did affect patient care.  The radiology value chain, of course, begins as early as the decision to image and extends well into appropriate follow-up imaging of identified lesions (Enzmann, Radiology 2012).

Maybe it’s time we as radiologists take ownership of the whole imaging process, from the decision to image all the way to follow-up.

Be a Radiology Informatics Visionary

In The Four Steps to the Epiphany, Stephen Clark describes an “Earlyvangelist,” with the prefix “early” referring to a champion a the very early stage of a product adaptation cycle.

Since our emphasis is on problem and not the product, a different term might be more appropriate.  I will refer to this person as The Visionary.

The Visionary comes from the “problem end” of informatics. The Visionary is observant and asks good questions. She has a pain point. She knows when things just don’t look quite right. She may not know what the solution looks like. She may not even know that a solution exists. Marketers like Visionaries because these people see problem and can see the potential of the new purchase.

The Visionary is what all radiologists interested in informatics should be.  We see the clinical problem in a way that no software developer and no administrator can see.  Sitting down and accepting the status quo runs the risk of burying the problem forever.

Relaxing the Quality MOC Requirements – Good News or Bad Omen?

In September, the American Board of Radiology (ABR) released a set of expanded options for satisfying Part 4 Requirements for its maintenance of certification (MOC).

The biggest change includes the ABR’s willingness to include additional areas (16 of them) of involvement in departmental quality and safety other than Practice Quality Improvement (PQI) as qualifying requirement. Continue reading

Hospital Profitability in Pennsylvania: A 2014-2015 Update (2 of 2)

In part 1 I presented an updated data set for Pennsylvania hospital financial performance and compare it against my 2010 analysis.

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Hospital Profitability in Pennsylvania: A 2014-2015 Update (1 of 2)

Is your hospital profitability suffering?  Is it being squeezed by a competitor? Or, is your hospital the one doing the squeezing?  Is it even making money?

As physicians we don’t often ask ourselves about the bigger organizational strategy.  However, it is hard to ignore the reality that hospital policies affecting us are often informed by numbers so hard to understand that sometimes we just pretend that logic doesn’t exist.

Maybe it’s time to do something about that.

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