Imaging 3.0™: Where Are We Now?
Taking stock as the radiology wide initiative takes hold and transforms the specialty
In last october's column, I wrote about how Imaging 3.0™ had taken hold across the profession. A year later, I'm pleased to report that it is embedding itself in our culture and informing every activity of the College.
We continue to gather success stories from around the country (and you can read them on our Imaging 3.0 website at www.acr.org/imaging3). From an ACO in Kansas where the radiologists are in the driver's seat (http://bit.ly/KansasACO) to an Indiana practice that demonstrated to a skeptical hospital administration the sheer breadth of the group's contributions to the health system, driving away the threat of losing their contract (http://bit.ly/Img3Indiana).
We had a big win on the policy front with the March 2014 legislation that mandated the use of clinical decision support for advanced imaging in the Medicare program, effective 2017. At the time of writing, we are still waiting for Medicare's decision on coverage of lung cancer screening. If, as we hope, CMS makes the right decision and extends this life-saving benefit to our seniors, it will be in large part because of the Imaging 3.0 approach that our team has taken. Members throughout the College have been building the program, which centers on the principle articulated by our board chair Bibb Allen Jr., MD, FACR: "All of the imaging that is necessary and none that is not."
We have told CMS that we will hold ourselves accountable for providing the highest level of care and commit to improving our knowledge through outcomes tracking and registry participation.
Meanwhile, the Imaging 3.0 toolkit continues to grow. Whether it is the ACR's Qualified Clinical Data Registry (a tool that will make participating in value-based payments significantly easier for radiologists) or the exciting products that health IT companies are developing to facilitate innovative ways for us to connect with patients, there are more and more ways to make your practice an Imaging 3.0 hotspot.
So is everything rosy in the Imaging 3.0 garden? Alas, there is always a thorn or two. I wrote last month about some continued frustrations delivered by CMS in the proposed rule. (Read more at http://bit.ly/ACREconChair) We know that CMS recognizes our specialty's commitment to value but that doesn't seem to stop them from trying to wrest a few more dollars of savings from our work. Is every radiologist and group on board with Imaging 3.0? Clearly we have more work to do, but the momentum is building. Those who have not embraced change are starting to look like outliers. Does the Imaging 3.0 toolkit contain everything we would like? Hardly. In my fantasy world, no patient ever has to make a phone call to schedule an exam or track down their images to take to a different provider. Every report is actionable, searchable, and meaningful to everyone who needs to access it. I hope to see the means whereby radiologists can seamlessly document their value-added activities during the workflow. We're getting there, but there are a lot of barriers.
We have work to do on every area of Imaging 3.0, but overall I am resolutely optimistic about our specialty's future. I know there is still anxiety out there, and I feel especially concerned for our graduating residents and fellows for whom the job market has been so difficult. Imaging 3.0 is the change that we hope will open up much needed opportunities for young physicians as practices recognize the value that these new graduates can bring.
Your economics team will continue to work tirelessly to secure fair reimbursement for the work you do. That is entirely congruent with the principles of Imaging 3.0: What we do for our patients is valuable, and we need to make our services available to those who need them. We'll continue to push for better tools and sensible payment policy to support you. But, very importantly, we will continue to learn from you and your successes. Because some of the most exciting changes are not happening in Washington; indeed, it is you who are creating them. Please share your stories with us.
By Geraldine B. McGinty, MD, MBA, FACR, Chair