Although image interpretation is an essential part of radiologists' value, there are
other ways in which we contribute to patient care. Part II of the value of imaging
series reviews current initiatives that demonstrate value beyond the image interpretation.
Standardizing processes, reducing the radiation dose of our examinations, clarifying
written reports, improving communications with patients and providers, and promoting
appropriate imaging through decision support are all ways we can provide safer, more
consistent, and higher quality care. As payers and policy makers push to drive value,
research that demonstrates the value of these endeavors, or lack thereof, will become
increasingly sought after and supported.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Physicians' views of the relative importance of thirty medical innovations.Health Aff. 2001; 20: 30-42https://doi.org/10.1377/hlthaff.20.5.30
- Delivery of appropriateness, quality, safety, efficiency and patient satisfaction.J Am Coll Radiol. 2014; 11: 7-11https://doi.org/10.1016/j.jacr.2013.07.016
- Where can $700 billion in waste be cut annually from the U.S. healthcare system?.(Thomson Reuters; Available at) (Accessed May 15, 2015)
- A systematic review of medical practice variation in OECD countries.Health Policy (New York). 2014; 114: 5-14https://doi.org/10.1016/j.healthpol.2013.08.002
- Nationwide Evaluation of X-ray Trends (NEXT): 2000–2001 survey of patient radiation exposure from computed tomography (CT) examinations in the United States [abstr].Radiology. 2001; 221: 161
- The ACR computed tomography dose index registry: the 5 million examination update.J Am Coll Radiol. 2013; 10: 980-983https://doi.org/10.1016/j.jacr.2013.08.030
- Available at) (Accessed May 15, 2015) (
- Dose tracking and dose auditing in a comprehensive computed tomography dose-reduction program.Semin Ultrasound CT MR. 2014; 35: 322-330https://doi.org/10.1053/j.sult.2014.05.004
- Standardized CT protocols and nomenclature: better, but not yet there.Pediatr Radiol. 2014; 44: 440-443https://doi.org/10.1007/s00247-014-3096-8
- RadLex Playbook.(Available at) (Accessed May 15, 2015)
- Radiology reporting, changes worth making are never easy.Appl Radiol. 2010; 39: 20-23
- Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee.J Am Coll Radiol. 2010; 7: 754-773https://doi.org/10.1016/j.jacr.2010.06.013
- Compliance with Fleischner Society guidelines for management of small lung nodules: a survey of 834 radiologists.Radiology. 2010; 255: 218-224https://doi.org/10.1148/radiol.09091556
- Ways to improve radiologists' adherence to Fleischner Society guidelines for management of pulmonary nodules.J Am Coll Radiol. 2013; 10: 439-441https://doi.org/10.1016/j.jacr.2012.10.001
- The ACR BI-RADS experience: learning from history.J Am Coll Radiol. 2009; 6: 851-860https://doi.org/10.1016/j.jacr.2009.07.023
- Setting the standard: in today's value-driven health care environment, standardized language in structured reports allows for improved patient care.(Available at) (Accessed May 15, 2015)
- Can clinical decision support change radiology practice?.(Available at) (Accessed May 15, 2015)
- Trends in the overuse of ambulatory health care services in the United States.JAMA Intern Med. 2013; 173: 142-148https://doi.org/10.1001/2013.jamainternmed.10221
- Overuse of computed tomography pulmonary angiography in the evaluation of patients with suspected pulmonary embolism in the emergency department.Acad Emerg Med. 2012; 19: 1219-1226https://doi.org/10.1111/acem.120121
- Effect of reimbursement reductions on bone mineral density testing for female Medicare beneficiaries.J Womens Health (Larchmt). 2012; 21: 1144-1148https://doi.org/10.1089/jwh.2012.35171
- Utilization management in radiology, part 1: rationale, history, and current status.J Am Coll Radiol. 2012; 9: 694-699https://doi.org/10.1016/j.jacr.2012.06.010
- ACR and AMA oppose RBMs for guiding appropriateness.(American College of Radiology Advocacy in Action eNews; Available at) (Accessed May 15, 2015)
- Appropriateness Criteria.(Available at) (Accessed May 15, 2015)
- Do clinicians use the American College of Radiology Appropriateness Criteria in the management of their patients?.AJR Am J Roentgenol. 2009; 192: 1581-1585https://doi.org/10.2214/AJR.08.1622
- Effect of computerized order entry with integrated decision support on the growth of outpatient procedure volumes: seven-year time series analysis.Radiology. 2009; 251: 147-155https://doi.org/10.1148/radiol.2511081174
- Effectiveness of clinical decision support in controlling inappropriate imaging.J Am Coll Radiol. 2011; 8: 19-25https://doi.org/10.1016/j.jacr.2010.07.009
- Effect of clinical decision support on documented guideline adherence for head CT in emergency department patients with mild traumatic brain injury.J Am Med Inform Assoc. 2014; 21: e347-e351https://doi.org/10.1136/amiajnl-2013-002536
- Impact of IT-enabled intervention on MRI use for back pain.Am J Med. 2014; 127 (e1): 512-518https://doi.org/10.1016/j.amjmed.2014.01.024
- Medicare imaging demonstration evaluation report.(Centers for Medicare and Medicaid Services Website; Available at) (Accessed June 3, 2015)
- Why you should think twice about the Medicare Imaging Demonstration.(The Advisory Board Company; Available at) (Accessed June 3, 2015)
- RAND study questions whether decision support really works.(AuntMinnie Website; Available at) (Accessed June 3, 2015)
- The clinical decision-support mandate: now what?.Radiol Bus J. 2014 (Available at)http://www.radiologybusiness.com/topics/policy/clinical-decision-support-mandate-now-what?nopaging=1(Accessed June 3, 2015)
- Clinical decision-making tools for exam selection, reporting and dose tracking.Pediatr Radiol. 2014; 44: 418-421https://doi.org/10.1007/s00247-014-3015-z
- Emergency physicians' knowledge and attitudes of clinical decision support in the electronic health record: a survey-based study.Acad Emerg Med. 2013; 20: 352-360https://doi.org/10.1111/acem.12109
- Use of an electronic health record clinical decision support tool to improve antibiotic prescribing for acute respiratory infections: the ABX-TRIP study.J Gen Intern Med. 2013; 28: 810-816https://doi.org/10.1007/s11606-012-2267-2
- Five reasons radiologist should embrace clinical decision support for diagnostic imaging.J Am Coll Radiol. 2014; 11: 533-534https://doi.org/10.1016/j.jacr.2014.04.016
- Radiologist–patient contact during the performance of cross-sectional examinations.J Am Coll Radiol. 2004; 1: 162-163https://doi.org/10.1016/j.jacr.2003.12.011
- The invisible radiologist.Radiology. 2011; 258: 18-22https://doi.org/10.1148/radiol.10101447
- Face of radiology campaign.Acad Radiol. 2009; 16: 517-520
- Imaging 3.0: what is it?.J Am Coll Radiol. 2013; 10: 229
- Radiologist manpower considerations and Imaging 3.0: effort planning for value-based imaging.J Am Coll Radiol. 2014; 11: 953-958
- Disclosure of imaging findings to patients directly by radiologists: survey of patients' preferences.AJR Am J Roentgenol. 1995; 165: 467-469
- Access to radiologic reports via a patient portal: clinical simulations to investigate patient preferences.J Am Coll Radiol. 2012; 9: 256-263
- Insight from patients for radiologists: improving our reporting systems.J Am Coll Radiol. 2009; 6: 786-794
- Direct disclosure by radiologists of imaging findings to patients: a survey of radiologists and medical staff members.AJR Am J Roentgenol. 1996; 167: 1091-1093
- Patient access to radiology reports: what do physicians think?.J Am Coll Radiol. 2010; 7: 281-289
- The social life of health information.(Pew Research Center website; Available at) (Accessed June 3, 2015)
- Health literacy: a manual for clinicians.American Medical Association and American Medical Foundation, Chicago, IL2003
- A critical review of the readability of online patient education resources from RadiologyInfo.Org.AJR Am J Roentgenol. 2014; 202: 566-575
- Can patients comprehend the educational materials that hospitals provide about common interventional radiology procedures?.J Vasc Interv Radiol. 2015; https://doi.org/10.1016/j.jvir.2015.04.029
- Radiology reporting: returning to our image-centric roots.AJR Am J Roentgenol. 2006; 187: 1151-1155
- On the logistics of interpretive radiology reporting: moving beyond procrustes.J Am Coll Radiol. 2009; 6: 544-546
- Preferences for structured reporting of measurement data: an institutional survey of medical oncologists, oncology registrars, and radiologists.Acad Radiol. 2014; 21: 785-796
- Impact of filmless radiology on frequency of clinician consultations with radiologists.AJR Am J Roentgenol. 1999; 173: 1169-1172
- The radiology report of the future: a summary of the 2007 Intersociety Conference.J Am Coll Radiol. 2008; 5: 626-629https://doi.org/10.1016/j.jacr.2007.12.015
- Radiology reports: examining radiologist and clinician preferences regarding style and content.AJR Am J Roentgenol. 2001; 176: 591-598https://doi.org/10.2214/ajr.176.3.1760591
- Survey of hospital clinicians' preferences regarding the format of radiology reports.Clin Radiol. 2009; 64 (395–396): 386-394https://doi.org/10.1016/j.crad.2008.11.009
- Understanding the hospitalists' and emergency physicians' needs and preferences from the radiology department and radiology report.AMCLC. 2014 (Available at) (Accessed June 3, 2015)
- Added value of selected images embedded into radiology reports to referring clinicians.J Am Coll Radiol. 2010; 7: 205-210https://doi.org/10.1016/j.jacr.2009.10.014
- A picture is worth a thousand words: needs assessment for multimedia radiology reports in a large tertiary care medical center.Acad Radiol. 2013; 20: 1577-1583https://doi.org/10.1016/j.acra.2013.09.002
- Traditional text-only versus multimedia-enhanced radiology reporting: referring physicians' perceptions of value.J Am Coll Radiol. 2015; 12: 519-524https://doi.org/10.1016/j.jacr.2014.11.009
- Setting value-based payment goals—HHS efforts to improve U.S. health care.N Engl J Med. 2015; 372: 897-899https://doi.org/10.1056/NEJMp1500445
- Radiology residents rounding with the clinical teams: a pilot study to improve the radiologist's visibility as a consultant.J Am Coll Radiol. 2014; 11: 326-328https://doi.org/10.1016/j.jacr.2013.04.012
- Integrating tablet-based videoconferencing with an image viewer and a shared PACS session to provide a platform for remote consultation for radiology studies.(Presented at the)2014 (Society for Imaging Informatics in Medicine Meeting)
- An evaluation of the impact of clinically embedded reading rooms on radiologist–referring clinician communication.J Am Coll Radiol. 2013; 10: 368-372https://doi.org/10.1016/j.jacr.2012.12.009
- Radiology's value chain.Radiology. 2012; 263: 243-252https://doi.org/10.1148/radiol.12110227
- Value management program: performance, quantification, and presentation of imaging value-added actions.J Am Coll Radiol. 2015; 12: 239-248https://doi.org/10.1016/j.jacr.2014.07.036
- “Wet Reads” in the age of PACS: technical and workflow considerations for a preliminary reporting system.J Digit Imaging. 2007; 30: 296-306https://doi.org/10.1007/s10278-006-1049-y
- Outside imaging in emergency department transfer patients: CD import reduces rates of subsequent imaging utilization.Radiology. 2011; 260: 408-413https://doi.org/10.1148/radiol.11101956
- Interpretation of outside imaging studies: solutions from a tertiary care trauma center.J Am Coll Radiol. 2012; 9 (e1): 591-594https://doi.org/10.1016/j.jacr.2012.01.008
- Trauma transfers and definitive imaging: patient benefit but at what cost?.Am Surg. 2013; 79: 301-304
- Transfer patient imaging: current status, review of the literature, and the Harborview experience.J Am Coll Radiol. 2013; 10: 361-367https://doi.org/10.1016/j.jacr.2012.09.031
- Curbstone consultations.AJR Am J Roentgenol. 2002; 178: 1353-1359https://doi.org/10.2214/ajr.178.6.1781353
- On-call resident outside study overreads: our department's experience streamlining workflow and improving resident supervision while providing a new source of revenue.Curr Probl Diagn Radiol. 2015; 44: 118-121https://doi.org/10.1067/j.cpradiol.2014.10.001
- Second opinion interpretations by specialty radiologists at a pediatric hospital: rate of disagreement and clinical implications.AJR Am J Roentgenol. 2012; 199: 916-920https://doi.org/10.2214/AJR.11.7662
Article info
Publication history
Published online: November 09, 2015
Accepted:
September 20,
2015
Received in revised form:
September 9,
2015
Received:
June 23,
2015
Identification
Copyright
© 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.