Redundancy in medical imaging: Causes and fixes

The data surrounding the sheer number of unneeded medical image records is eye-opening. According to a survey report from consulting firm peer60, executives, such as CMOs and department heads from 196 U.S. hospitals, revealed the medical system spends at least $7.47 billion on unnecessary imaging every year. Shockingly, this is a low estimate, with the upper end possibly reaching just shy of $12 billion. Defensive medicine was a cause of the unnecessary imaging according to nine out of 10 of the respondents, with patient demand and physician's unfamiliarity with the proper tests also coming in as popular responses.

Half of the respondents said more than 10 percent of the medical imaging conducted in their company was redundant. This represents a substantial cost inefficiency and begs the question of why such unnecessary and redundant images are created.

Possible answers include:

  • Physicians naturally want to err on the side of caution. This means they might order duplicate tests or give in to patients who demand additional exams, even when they aren't medically necessary.
  • The data can get mixed up. Information is not always catalogued in the right area, so wires can get crossed, resulting in redundant orders. Reducing unnecessary imaging can only be done through electronic exam ordering, but many providers don't believe they have an adequate system in place to allow simple sharing.
  • Patients visit multiple physicians, resulting in multiple orders and images, especially in cases where the physicians are not linked together by any networks.
  • Payment models often encourage a volume of imaging versus quality, so scans have a financial incentive tied to them.

What's happening within the industry and in technology innovation to reduce redundancy of medical image records?

  • The technology to tackle this problem exists. Technology tools are available that comply with HIPAA standards and can keep patient medical images secure. The industry needs to embrace the latest technology and use its prowess to help streamline the image records process.
  • Early adopters include leading medical organizations that are using the cloud to better organize images for easier access and sharing. Standout organizations will be able to trumpet their successes in using technology to better manage images, and should drive adoption among other facilities.
  • It's important for physicians to have access to imaging data within the EMR platforms they are already using. Many firms offer solutions which consolidate imaging within the EMR, which eliminates the task of logging into two systems and moving back and forth between browsers.
  • The creation of image portals for patients and physicians provides simple and ready access to images, reducing the need to reorder scans. Instead of relying on VPNs or CDs sent in the mail, a cloud-based portal is used. Patients can more easily access their own records for sharing with other healthcare providers, and physicians can quickly send images for referrals or to aid in the discussion of treatment options.

The industry is shifting its focus on the problem of unnecessary medical imaging. According to the peer60 survey respondents, more than half noted inappropriate imaging as a main priority. The longer-term goal is for medical imaging to be shared seamlessly between patient and provider (in a secure setting), and an elimination of the various factors that encourage unnecessary ordering.

Morris Panner, DICOM Grid’s CEO, is an experienced software executive, having recently built and sold an industry-leading business process software company, OpenAir, Inc., to Larry Ellison’s on-demand software company, NetSuite.Morris built the company from inception to a global company with Fortune 500 clients. Previously, Mr. Panner had worked in healthcare IT, partnering to form an early teleradiology venture. 

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