The Quality-Technology Paradox

Quality-Technology

The Quality-Technology Paradox

Monday, December 4, 2017
Bruce Reiner, MD
Chief Medical Officer
RadSite

While technology developments in medical imaging are routinely thought of as promoting innovation, evidence-based clinical practice and better quality, it could be argued that recent trends may have unexpected and unintended outcomes.  We need to understand how different pressure points in today can impact the practice of medicine, especially as it relates to imaging. 

Let me explain.  In the old days, the radiology reading room and film processors were centrally located. Technologists and radiologists would routinely congregate in common areas offering constructive criticism, helpful hints, and impromptu educational sessions to improve medical image “film-based” quality.

In today’s practice environment, this type of interaction is rare.  Technologists and radiologists are often forced to prioritize productivity over quality, due to heightened workflow and fiscal demands. Additionally, the physical layout of the radiology departments is far less centralized today, with technologists and radiologists peripherally located and practice in relative isolation to each other—diminishing opportunities for collaboration and continuous learning.

For example, the time it takes to solicit a radiologist or technologist opinion on a quality deficiency often exceeds the actual time it takes to acquire the patient images—creating a disincentive to improve QA. Furthermore, technologists and radiologists are largely evaluated (and financially compensated) based on productivity, maximizing the incentive for output rather than quality. This has contributed to the overall trend of commoditization of radiology practice, which promotes “survival of the cheapest” versus “survival of the fittest”.

If we want to embrace and reprioritize quality in practice, we must promote and invest in more rigorous quality standards, quality centric education and training, and economic incentives tied to quality metrics. RadSite’s accreditation programs offer the independent QA needed to improve the field of medical imaging.

To learn more about the topics addressed in this blog, see the following articles:

  1. Reiner, BI. Creating Accountability in Image Quality Analysis. Part 1: The Technology Paradox. J Digit Imaging 2013; 2: 147-150
  2. Reiner, B, Siegel, E. Decommoditizing Radiology. J Am Coll Radiol 2009; 3: 167-170

Final Thoughts

RadSite is a leader in promoting quality-based imaging standards – along with safety and business efficiency practices in health care. RadSite’s MIPPA Accreditation Program (MAP) offers insurers an excellent contract management tool to focus on outcomes, costs and a quality improvement framework that brings value to your organization’s management of imaging services. We also offer educational programs, publish issue briefs and underwrite research on a complimentary basis to raise awareness of patient safety issues and to promote best practices. Call us at 443-440-6007 or click here to learn more about how we can help you improve quality and cut costs in medical imaging.