ACR issues recommendations on adding value to radiology practices

A white paper published in this month's issue of the Journal of the American College of Radiology lists a number of recommendations on how radiologists can provide value during a time in which their practices are rapidly moving away from a traditional medical business model.

The recommendations were issued by the Task Force to Evaluate the Value-Add Impact on Business Models, which was formed in January 2008. It was tasked with evaluating and providing insights into the value of evolving and novel radiology practice business models.

The white paper, written by Frank Lexa, MD, from the Wharton School at the University of Pennsylvania in Philadelphia, and colleagues, included 12 recommendations, as follows:

• The ACR should support the investigation and use of performance measures in radiology to provide a rational basis for the documentation of high-quality practice that provides added value, which can be applied at the level of the radiologist, the practice and the larger healthcare enterprise.

• The ACR should reinforce and extend beyond current efforts to encourage radiologists to meet with at least five patients a day. In addition, the ACR should promote a program that would have radiologists make five phone calls a day to clinicians to increase the prominence of radiologists and increase their value.

• It should develop programs for its membership to encourage greater patient interaction, not only to provide value to patient and families, but to increase the visibility and value of radiologists as consultants and physicians.

• The college should work together with national agencies to develop better support for the added work of comparing with outside images and for conference presentation of case reviews.

• The ACR should actively promote its Appropriateness Criteria (evidence-based guidelines to assist physicians and other providers in making the most appropriate imaging decision for specific clinical conditions) to private payors and other entities with forms that can be used across an enterprise.

• RADPEER or other peer review processes should be adjusted to include measurements of overcalls and other forms of misinterpretation of images.

• Next-generation RADPEER-type instruments that use national, anonymous review systems should be created to help develop national standards for quality and practice levels. These kinds of systems add value to both traditional and new business models, and the ACR is best suited to develop and deploy these systems.

• The ACR should develop systems that are widely accepted and used both within and without the radiology community as indicators both of radiologist quality and professionalism.

• The college should support active research on the value of imaging and appropriateness to improve the value of the Appropriateness Criteria.

• Partnerships should be explored by the ACR that will allow sophisticated IT applications of the Appropriateness Criteria.

• Closer relationships with stakeholder groups such as patients, advocacy groups and consumer alliances, should be developed by the ACR to better educate those groups about the value of radiologists in the healthcare enterprise; improve the understanding of radiologists and their groups in how to provide better service; and heighten the visibility of radiologists.

• The ACR should engage the organizations and alliances promulgating informatics standards to ensure that interfaces are available that facilitate functions relating to value-added practice.