The health care landscape has endured massive overhauls in the last two decades, from the Health Insurance Portability and Accountability Act to meaningful use and the Affordable Care Act. Federal initiatives have forced providers in all corners of the industry to change how they manage their organizations, including medical imaging.
According to AuntMinnie.com, PACS systems have operated as standalone software for many years with radiologists making the bulk of purchasing decisions. However, the use of PACS has changed with the advent of electronic health records, and more providers are looking to integrate the technology with their diagnostic imaging. Health systems include IT specialists, chief information officers and other stakeholders from the organization in decision-making for equipment rather than relying solely on radiologists.
While collaboration is essential to maintaining profitability, it can hinder radiologists’ options when it comes to selecting the optimal PACS. They could go back and forth with CIOs, with one side opting for an affordable system with minimal capabilities, and the other leaning toward an expensive interface that is fully integrated with EHRs and has robust reporting functions.
Can PACS survive?
The ACA and other federal legislation seek to improve quality of care by making doctors more accountable for their efforts. For example, the Protecting Access to Medicare Act of 2014 includes language that requires radiologists to update their imaging systems to accommodate for lower radiation doses. This stipulation aims to reduce instances of radiation-induced cancers, an inherent risk of repeating exams.
For radiology, the new goal is to improve and follow appropriateness criteria for digital imaging. This might call for numerous discussions about budgets to determine if equipment needs to be updated or replaced in the coming years. Products like vendor neutral archives will begin to become more prevalent, with providers trying to bolster health information exchange across facilities.
With changes forthcoming, radiologists will amend their operations, setting their sights on reducing readmissions and clinical errors. But do these mandates affect how they should handle radiological mistakes?
Should radiologists apologize?
As evidenced by the federal government, accountability has become a huge component of the health care industry. Diagnostic Imaging explained that providers are constantly working to reduce medical errors, as they can have serious consequences for patients. According to an article from the Institute of Medicine, published in the late 1990s, as many as 98,000 people died each year as a result of radiological mistakes that could have been prevented. This includes factors such as radiation overexposure and missed diagnoses.
But with physicians from all specialties being held more accountable for their professional decisions, a reduction in serious medical errors is sure to follow. Radiologists have to expect that mistakes will be made throughout the course of their time with various practices, but must be sure that they are adhering to procedure and error policies.
Instead of removing themselves from the situation, radiologists need to face mistakes head on by practicing more openness with patients and their families. An apology gives patients a straight story about what happened and insight into what is being done to remedy the error. In addition, hospitals and other health facilities have to change existing systems to reduce the likelihood of errors.
Adopting newer PACS that are integrated with EHRs and focusing on minimizing clinical mistakes may be the key to improving quality of care in the U.S. As the effects of the ACA and other legislation begin to roll out, health care providers will need to shift their gazes internally to ensure that errors are reduced and patients always experience the best treatments possible.
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Ronny Bachrach
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