vRad Analytics Helps Imaging Client Reduce Costs, Improve Care

ETMC A recent AXIS Imaging News story highlights how vRad’s client East Texas Medical Center Tyler (ETMC-Tyler) used vRad Analytics to answer the following questions about purchasing a $3 million CT scanner:


  • Does our CT imaging volume support the capital purchase of a third CT scanner?
  • How do we stack up against best practices among other Level I Trauma Centers?
  • If we invest in a third CT, how soon would our hospital recoup its investment?

The answers—based on their data rather than opinions—gave them the confidence to make the purchase, according to Dianne Adelfio, VP of Operations, ETMC-Tyler.

Building on this success, Adelfio then turned to their ultrasound program and, after further review, found a way to improve their staffing plan and added eight additional slots for patient appointments.

In addition to providing better and more convenient service, Adelfio points to reduced overtime costs: $30,000 in just the first 3 months. This shows that having the right access to the right data can help make inform decisions about optimizing staffing and imaging utilization.

Read the full article.

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Finding More Ways to Help Clients Succeed

RCHD LogovRad partners with clients in many ways to positively impact patient care. This can mean working to promote your imaging services to patients.

Recently, vRad’s communications team provided promotional support for Reeves County Hospital District’s (RCHD) first breast cancer screening open house. Based in Pecos, Texas, RCHD provides health care services to the people and communities of Reeves County and adjacent West Texas communities.

Working with the Director of Radiology Juan A. Ramirez RT (R), RSO and Marketing Director Venetta Seals, the team wanted to reach as many women as possible. Along with other RCHD efforts, vRad conducted media relations and distributed a press release to local outlets, securing a radio interview on KIUN-AM during one morning commute before the event.

Arlene Sussman, MD vRad’s Medical Director and head of women’s imaging, who reads mammograms for RCHD, raised awareness of the importance of screening, especially for women in rural areas. “Breast screening is still the single best tool we have in identifying breast cancer at an early stage,” she said. She also noted that telemammography is a “compassionate, smart way to deliver healthcare to women who may not otherwise have access.”

vRad’s Communications Team distributed the press release to contacts at more than 30 outlets in the area; a notice also appeared in The Fort Stockton Pioneer just before the event.

RCHD was pleased with the overall PR results. “Our first Annual Mammo-Mania 2014 event at RCHD was a success. We had more than 35 women show up during that day, which exceeded our expectations. Most of the ladies had never received a screening mammogram,” said Mr. Ramirez. “That’s what this event was all about – raising the awareness in our community and surrounding communities. Thanks to your help, I believe we have achieved this.”

He concluded with, “Thank you all at vRad for helping us – from the clinical and technical aspects to the PR and marketing support. It contributed to making the event a success.”

vRad is not your typical radiology group. We believe that partnering with clients in many areas – from subspecialty to analytics to PR/marketing support helps raise awareness of the unique high-quality imaging services our clients can offer patients.

Ask us how we can do more to partner together.

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vRad CMO Dr. Strong to Provide CME-approved Lecture in Russia February 17th & 19th

benjamin-strongBenjamin W. Strong, MD (ABR, ABIM), will speak at the first International Multidisciplinary Conference of Ramsay Diagnostics being held in Moscow on February 17, 2015, and in Saint Petersburg on February 19, 2015. His lecture, entitled Clinical Information, Modalities and Studies: How It All Fits Together has been approved for 2 AMA PRA Category 1 Credit(s) ™.

“I am pleased to have the opportunity to participate in the inaugural Ramsay Diagnostic Medical Conference,” said Dr. Strong. “vRad radiologists are dedicated to sharing best practices to improve healthcare worldwide. In addition to participating in educational conferences and events, our practice offers free CME credits every year allowing radiologists easy access to continuing education. In 2014, vRad awarded over 1,400 AMA PRA Category 1 Credit(s) TM to over 600 radiologists around the globe.”

Dr. Strong is board certified in radiology and internal medicine. He is licensed to practice in all 50 U.S. states and also holds credentials to read in Russia and a number of foreign countries. He earned his medical degree from the University of Arizona College of Medicine in Tucson, completed his residency in internal medicine at Dartmouth-Hitchcock Medical Center in New Hampshire, and completed a radiology residency and a fellowship in musculoskeletal MRI at the University of Arizona, Arizona Health Sciences Center in Tucson. In 2014, he was chosen one of the “Top People to Watch in Radiology” by Diagnostic Imaging, a leading online community for medical imaging professionals.

The Conference, sponsored by GE Healthcare in Russia, will bring together surgeons and other clinical professionals to discuss imaging for abdominal oncology. Visit http://ramsaydiagnostics.ru/o-kompanii/1-ya-mezhdunarodnaya-konferenciya for more information about the Conference.

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Diagnostic Method to Watch in 2015: 3D Mammography

what you need to know blocksTomosynthesis mammography, also known as three dimensional (3D) mammography, is a new way of acquiring images of the breast.

It is similar to a traditional 2D mammogram from the patient’s perspective. The test still requires that the patient must experience compression of the breast, x-ray exposure to acquire images, and remain still while the x-ray is being taken.

The difference is that the arm of the machine moves in an arc over the patient, so instead of acquiring just one image, it acquires many images from many different angles. The images are then processed by a computer and displayed in such a way that allows the physician to see “through” the breast tissue.

Preliminary studies are confirming what we initially believed to be true: 3D mammography results in fewer false alarms. Ten percent of the time a woman is called back for additional images to clarify something seen on the mammogram.

Most of the time, a call back for additional images proves that all is well, and no cancer is present. 3D mammography is good at reducing the need to call back patients for additional imaging because seeing through the breast tissue better can significantly reduce that overlap factor.

Additionally, preliminary studies are showing that 3D mammography is detecting more cancers. This is likely to be the case for younger women whose breast tissue tends to be denser and more difficult to “see through.” While the radiation dose is higher than that for traditional 2D mammography, it is still well within allowable and safe limits. The hope is that it will also make the screening more comfortable for women.

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An Enterprise View of Radiology: vRad CIO’s Top 5 RSNA 2014 Observations

RSNA2014Having just returned from the 100th Radiological Society of North America (RSNA), I continue to be amazed by its scale even after attending for nearly 20 years. The educational sessions offered, the vendors demonstrating their offerings, and the sheer magnitude of the opportunity to network with industry peers continue to impress.

Here are my 5 key takeaways from this year’s visit:

  1. Strong Educational Sessions. Meaningful Use is “Uniquely Gray” … I appreciated the session “Health IT Incentive Programs: Experience from Radiology Practices in Hospitals and Health Systems,” which presented a balanced view of how radiology practices should think about Meaningful Use. Each presenter offered their experiences, which were in stark contrast to the others. After a lively audience debate, the session validated that Meaningful Use for radiology practices isn’t black and white — each needs to consider their unique situation before deciding to move in that direction.
  2. Analytics continue as expected. Natural Language Processing (NLP) On the Rise … vRad continues to invest heavily in analytics solutions both internally, with analytics for operational and clinical insight, and externally by partnering with clients (radiology practices and hospitals alike). While I didn’t find anything new or compelling, I was encouraged to see a number of educational sessions and vendors focused on how NLP is important beyond just coding and billing. The insights that can be gleaned using NLP on a radiology report are endless — now imagine turning NLP lose on more than the current report (actively during dictation – think critical results, prior reports, other clinical documentation). I know Analytics and NLP will continue to be key discussion topics throughout 2015 – and in Chicago next year as well.
  3. The “Bloom is Off the VNA Rose” … I understand the value of integrating more than Radiology/DICOM imaging and appreciate the complete patient record approach. I was part of the Acuo Technologies acquisition by Perceptive Software that provided the first integrated VNA/ECM approach and brought all patient data and content forward, typically presented through the EMR. That said it has been two years now … shouldn’t we expect more? What about data sharing? What about approaching big data through the VNA/ECM solution? I’m pleased with the consolidation occurring within the image/data sharing space (Nuance/Accelerad, Perceptive/GNAX), but where will these larger players take it? What is the strategy? Big Data is only cutting its teeth at this point, but who better than a VNA/ECM/content management player to start thinking about what this means for healthcare? It isn’t just about data storage or retrieval; it should be about what does the data mean, and when can we begin to predict outcomes?
  4. Radiology and Pathology Finally Coming Together? Especially in the oncology space we still don’t have a good solution around how radiology and pathology results can be integrated. I was surprised to hear about how pathology solutions provided by traditional major radiology players are coming together. I was even more surprised to see the infamous PACSMan reference it in his AuntMinnie interview – http://www.auntminnie.com/index.aspx?sec=rca&sub=rsna_2014&pag=dis&ItemID=109569&wf=6302 (~ 4 minute mark. You may have to log in to view).
  5. RSNA Spans the GlobeRSNA has always been a good place to engage the international market, and this year was no different with a noted increase in international participants. As vRad looks to expand its offerings, the international market looks promising with a number of developed and underdeveloped teleradiology markets that could be well served by an international teleradiology player with vRad’s scale.
  6. Teleradiology/Telemedicine Workflow Solutions Appearing … (OK – so I had 6 observations) It was interesting to find new companies either introducing or driving harder toward specific teleradiology/telemedicine workflow solutions. Put the viewer and hardware/infrastructure aside for a moment and think solely about the complexity and requirements of being a national or international telemedicine provider (demand forecasting, capacity scheduling, clinical and operational workflow, financial/invoicing/compensation, reporting, etc.). This is clearly a market that will develop as the telemedicine space grows.

Bottom line: RSNA continues to impress. I was even astonished by innovative offerings from the larger players (especially around pathology).

However, I do continue to be disappointed by the attention given to federal programs/incentives (like Meaningful Use), plus the fact that organizations spend so much time focusing on specific financial models they think are in vogue. Why not listen to your clients and learn how they want to purchase and invest in solutions?

It is obvious healthcare IT still stands to learn more … listening is a good first step. Will go back in 2015 to listen some more.

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“Radiologists are known as – and trained to be – the ‘doctor’s doctor’ for good reason and must remain in that role.”

Doc consulting_smallIn response to a November 24 New York Times article, Dr. Strong submitted the following letter. It outlines his position on radiology’s ability to provide overall patient care and why radiologists are best equipped to be the doctor’s doctor rather than a patient’s.

To the Editor:

As a radiologist who has also worked as an ED physician (residency in internal medicine at Dartmouth-Hitchcock Medical Center with a subsequent radiology residency and a fellowship in musculoskeletal MRI at the University of Arizona, Arizona Health Sciences Center in Tucson), I have first-hand, hands on knowledge of both sides of the issues raised in Gina Kolata’s recent article, “Radiologists Are Reducing the Pain of Uncertainty,” (Nov. 24, 2014).

As a radiologist, I experienced the consequences of trying to get more involved in clinical decision making and patient interaction. Because of my prior training in internal medicine, I made great efforts to bridge the specialties by talking to patients, reviewing histories and lab values, and presenting a diagnosis with associated treatment recommendations.  Despite my best intentions, my interactions confused patients and irritated referring clinicians to no end; had it continued, I would have been universally despised and unable to provide effective and credible care.

The radiologist and the referring physician are separate for a reason: there is simply not enough time in the world to do both jobs well. Most important, though, radiologists simply don’t have all of the information required to help treat and care for a referred patient, as aptly pointed out by Dr. Beaulieu.

Radiologists can’t answer – and shouldn’t answer – the “Now What” question patients undoubtedly ask. Patients should only speak with radiologists once they understand and accept that the radiologist has expertise in interpreting the image only – not in what course of care patients should or can pursue. The scan is a snapshot, a mile marker on a roadmap of the patient’s overall course of care. It is a diagnostic tool – albeit a critical one – but not an end in and of itself (contrary to what some patients think) used by the patient’s physician, not the patient.

Imparting clinical diagnoses and making treatment recommendations are best left to physicians who have access to a patient’s entire medical record and history. These doctors also have a relationship with the patient, know their mindset and understand how they like to receive information. They are current on the most effective therapies and procedures to treat a patient’s specific condition based on objective information a radiologist provides, as well as other clinical information. And, they can speak with the patient face-to-face in the privacy of a hospital or office environment; the radiologist interpreting the patient’s images are most often geographically separated from the facility in which the images were acquired.

Based on experience, I also believe that having one point of contact for a patient is the best way to achieve superior patient-focused care. The likelihood of a radiologist making an erroneous statement that directly conflicts with a previous statement made by a referring clinician increases with every word uttered to the patient by the radiologist.  That’s not a recipe for “reducing pain,” but rather for increasing anxiety – and legal actions.

I accept that the ACR and RSNA would like to work to make radiologists more accessible to patients; however, they cannot forget this basic tenant: Radiologists are known as – and trained to be — the “doctor’s doctor” for good reason and must remain in that role.

If the ACR and RSNA forget this, their initiatives are doomed to fail and will only create more uncertainty, stress and confusion for patients.

Benjamin W. Strong, MD (ABR, ABIM) Chief Medical Officer, vRad

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Varicose veins “more than just a cosmetic problem,” warns DII’s Aaron Shiloh, MD

VV_imageAaron Shiloh, MD, Chief of Interventional Radiology Services at Diagnostic Imaging, Inc. (DII), a vRad’s Alliance Partner, states it is a myth that varicose veins are merely a cosmetic problem.

What Are Varicose Veins?

Normally, the veins in our legs have valves that allow blood to move in one direction from the lower limb toward the heart. These valves open when blood is flowing toward the heart and close to prevent the backward flow of blood.

Varicose veins, which can look like lumpy veins, form in both men and women when these valves weaken and don’t close correctly, which can lead to blood flowing in the wrong direction and impair blood drainage from the legs. Varicose veins symptoms can include pain and swelling, as well as restless leg syndrome or ulcers.

To find out more about who is prone to varicose veins, why it is a progressive disease, and possible treatment for varicose veins, please watch Dr. Shiloh on the web series “Aria’s Medical MythBusters.” The web series explores everyday health and wellness questions, concerns, and old wives’ tales and finds out if they are facts or myths.

Click here to watch Dr Shiloh dispel myths about varicose veins.


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ICD-10: It is Time to Commit

Preparing a radiology practice for ICD-10 is challenging. Why? Not only must we educate and prepare our radiologists to provide the level of detail required by ICD-10 coding, but we must also make sure that our referring physicians are prepared to provide the same level of detail when they order a radiologic exam.

Since radiologists are dependent on the referring physician for pertinent information related to an ordered exam, they may be prone to thinking that ICD-10 coding is not their problem. What our radiologist must understand is that the referring physician is equally dependent on them. The treating physician must be able to document and code from our radiologic findings.

Keep in mind that for outpatient coding (Medicare Part B), the diagnosis code is assigned based on positive findings in the radiology report. When the finding is not definitive or negative, the code is assigned based on the diagnosis provided on the order (the indication). If the information provided in the indication and/or the finding sections of the final report are unspecific, assigning a diagnosis code for the procedure will be difficult or
impossible in ICD-10 coding.

Greater specificity will be needed in radiology reports to assign ICD-10 coding
to the findings. Details such as specific anatomical location, the severity or
acuity of the condition, the context, and the story of the patient’s condition
must be included in the radiology report.

It is time for radiologists to commit to ICD-10 and ICD-10 coding and embrace training opportunities that will help them prepare for this inevitable change.

Sharon Roeder, CPC

Manager of Payer Coding and Compliance
ICD-10 and ICD-10 coding vRad expert

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Breast Cancer Awareness Month is here. We have much to be thankful for.

The mortality rate from breast cancer continues to decline as we discover more and better improved methods of detection and treatment.

We also have much to celebrate; we continue to raise awareness and much needed funds both through individual drives and the National Institute of Health. And we are making great strides in elucidating not just the causes of breast cancer but the cures.

But until there are no breast cancer deaths, only survivors, until the face of this disease is wiped from our lives completely, we will continue to find ways to beat this disease with
everything we have.

I encourage you to wear a pink pin this month in solidarity with our mothers, sisters, daughters, and friends. We need to show we care with this tiny but very important act. Be a part of the cure.

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Examining Breasts: A Teaching Moment on the Mammographic Signs of Breast Cancer

Earlier this month, I gave my fourth annual national CME WebEx lecture on Breast Imaging and Intervention through the University of Arizona. I have always enjoyed teaching and part of my current responsibilities includes teaching radiology residents.

I consider it a success when at least one resident in each class decides to go
into breast imaging as a specialty. It makes me feel like I have done my job
well. This year’s lecture was a bread-and-butter one. It is a back-to-basics
lecture on the mammographic signs of breast cancer. There are so many
additional wonderful tools for helping us find and treat breast cancer; however
the single best screening tool still remains mammography.

We may have dressed up the modality by making it digital or making it three
dimensional, but it is still the basic two views of both breasts that serve us
the best. While it is not perfect, it is about 90 percent sensitive or accurate
in finding breast cancer. We need to continue to educate those around us to its
continued and timed earned value in our fight against breast cancer.

You can find a recording of this year’s talk about mammography and the mammographic
signs of malignancy on vRad’s site by clicking here.

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