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Convergence in Diagnostic Care: How Patient, Payor, and Market Dynamics Create Opportunities for Radiology and Imaging Providers (Part 1)
May 13, 2024
This blog is part of a series. Read Part 2 here.
I was pleased to present at the RBMA 2024 Paradigm conference in April. In our session, “Convergence in Diagnostic Care: Opportunities for Growth and Partnership,” my colleague, Harley Ross, and I discussed several topics, including:
Understanding the patient, payor, and market dynamics driving the convergence of radiology with other diagnostic disciplines and venues.
Identifying opportunities for collaboration and partnership within and beyond your practice’s geography and ecosystem.
Crafting a growth-oriented strategic plan for your practice that considers payor policy trends.
This first post in a two-part series will address how patient, payor, and market dynamics create opportunities for radiology and imaging providers. Leveraging these opportunities can set practices up for long-term success.
Trends Impacting Radiology Care Delivery
Remote Healthcare Services – The adoption of telemedicine and remote healthcare services has surged in the past few years, following the pandemic. This trend will likely continue; it offers patients convenience, improves access to care, and reduces the burden on traditional healthcare facilities. Remote interpretation of imaging studies also enables radiologists to provide expertise across geographical barriers.
Artificial Intelligence (AI) – AI, including machine learning are transforming healthcare, particularly in radiology, by enhancing diagnostic accuracy, driving workflow efficiencies, and supporting personalized treatment planning. AI has proven effective at analyzing medical images, detecting abnormalities, and facilitating radiologist interpretations. AI-driven predictive analytics also help healthcare practitioners identify at-risk patients and optimize treatment strategies. (Note: AI is also driving efficiencies in the revenue cycle.)
Advanced Imaging – Advances in genomics and molecular imaging, as well as data analytics, have facilitated the shift towards personalized medicine – tailoring treatments based on individual genetic makeup, biomarker profiles, and disease characteristics. This approach leads to better outcomes and reduces adverse effects. Radiology is vital in providing imaging modalities for targeted therapies and treatment monitoring.
Value-Based Care – The continued emphasis on value-based care makes improving patient outcomes while reducing costs essential. Healthcare reimbursement models are evolving to place incentives on quality and efficiency instead of the volume of care delivered.
Patient Satisfaction – Patient satisfaction remains a top priority for healthcare providers. Radiology is no exception. Radiology and imaging practices are adapting by implementing value-based initiatives such as providing comprehensive imaging, reducing unnecessary tests, and participating in accountable care organizations.
Collaboration – Healthcare’s innate complexity demands multidisciplinary collaboration. Team-based care models involving radiologists, clinicians, pathologists, and other specialties ensure comprehensive patient management. For example, this approach facilitates multidisciplinary tumor boards for cancer care. A team-based approach also involves shared decision-making, where radiologists increasingly serve as consultants, working closely with other healthcare professionals to optimize diagnostic and therapeutic strategies.
Digitalization – With the digitalization of healthcare data and increased connectivity of medical devices, cybersecurity, and data privacy have become paramount concerns. Protecting patient information, securing medical imaging systems, and ensuring compliance with regulations such as HIPAA are essential for maintaining trust and confidentiality in healthcare delivery and radiology practices. (Note of clarification: Digitization focuses on converting and recording data; digitalization involves developing processes and changing workflows to improve manual systems.)
Expanding Healthcare Distribution Model
The healthcare ecosystem is becoming increasingly distributed and decentralized. As seen in the graphic below, several key drivers are expanding the traditional care model to include more alternative care options. Many of these drivers are linked to patient demographics, socioeconomics, and access to care.
Many drivers put increasing pressure on the patient’s dollar through higher patient financial responsibility. So, not only is the healthcare delivery ecosystem changing, but so is patient behavior, patient expectations, and the financial healthcare ecosystem. Whether the payment comes from a payor or the patient, radiology and imaging practices compete for the payment. In today’s distributed healthcare model, where patients have more avenues than ever before to seek care, including non-traditional healthcare market entrants, that competition intensifies.
How These Dynamics Impact, and Reflect, Patient Behavior and Expectations
Meeting patient expectations is proven to improve both clinical and financial outcomes. Today’s patient is highly engaged and informed, expecting:
- Convenient, timely access
- Engaged, personalized care
- Clear communication
- Cost transparency and predictability
Three main factors influence patient behavior: Technology, Financial, and Consumerism. The financial dimensions impacting patients are those we hear about every day – inflation, rising housing costs, escalating interest rates, and heightening levels of consumer debt, just to name a few. As patients face mounting financial pressures, they’re more likely to scrutinize healthcare costs – and possibly delay or even forego care in to address areas of greater financial needs. Consumers are price-sensitive, and this impacts their healthcare choices as well.
Financial considerations dovetail nicely into consumerism. On the one hand, people are accustomed to having options for products and services. Cost is but one lens through which customers may evaluate a provider or clinical service (an evaluation intensified by today’s higher level of patient financial responsibility, driven by the propagation of high-deductible payor plans). Others include quality of care, familiarity, and convenience. Long story short: Patients are highly likely to shop around.
And finally, technology plays a massive role, too. Examples of how technology influences patient behavior include a patient’s ability to access information online, digital health tools, wearables, remote monitoring, the accessibility of telemedicine, and self-service capabilities. How patients engage digitally with their healthcare significantly impacts their experience. Patients have more options for healthcare delivery and management. Choosing convenience can sever the traditional connection to brick-and-mortar hospitals or primary-care settings.
But technology is more than a driver of patient behavior. It’s a tool. A catalyst. Technology (and data) empowers consumers to navigate their healthcare journey – inspiring a more informed, more connected patient experience. Several technology trends include:
- Digital pathology, imaging, and AI adoption and acceleration
- Consumer-driven technology to manage health
- Routine/basic healthcare moves to neighborhood pharmacies and telehealth
- Acceleration of data use (data to analytics to AI)
Conclusion
Now that we’ve examined the dynamics driving diagnostic convergence, we will address how radiology and imaging fit into the bigger picture in our next postarticle. Beyond diagnosis, radiology increasingly enhances patient care by contributing therapeutic guidance and minimally invasive interventions, such as imaging, to perform procedures such as biopsies and tumor ablations. In a distributed healthcare ecosystem, this presents opportunities to evolve the role of radiology and participate in new partnerships with hospitals, health systems, pharmaceutical companies, and technology providers. That, in turn, translates into practice growth.
Exploring and pursuing partnership opportunities takes time and focus. To buy yourself that space, optimal financial performance is key. How is your practice doing?