HHE Radiology and imaging supplement 2018 | Page 5

radiology and imaging
Value-based radiology
Creating value and contributing to patient outcome in radiology
departments starts with well-organised utilisation plans, shorter waiting times,
appropriateness criteria, structured and timely reporting and continuous
research for better imaging, intervention and therapy
Oyunbileg von
Stackelberg PhD
Carlos Francisco Silva
MD
Hans-Ulrich Kauczor
MD
Department of Diagnostic
and Interventional
Radiology, University
Hospital of Heidelberg,
Germany
Healthcare delivery is experiencing a great
transition and the term ‘value-based healthcare’ is
on everybody’s lips nowadays. The theory behind
this term is that the healthcare providers are paid
based on a patient’s health outcome and not for
the amount of service they delivered. Outcome
differs depending on the medical condition
including comorbidities and is not easy to
measure. For example, the most important
outcome for cancer patients is survival; however,
as for many other conditions, time required for
recovery, complications, adverse effects, pain,
psychological stress, sustainability of health and
long-term consequences of the therapy could
define outcome, and so the value of the
healthcare. Care for a medical condition usually
involves different specialties and a number of
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HHE 2018 | hospitalhealthcare.com
interventions, thus the value for the patient can
only be achieved by the combined efforts of all
players over the full cycle of care. The benefits of
any one intervention for ultimate outcomes will
depend on the effectiveness of further different
interventions throughout the care cycle. 1 The
specialty of radiology is an important outcome
influencing players in the whole healthcare cycle,
whether contributing to diagnosis, or by minimal
invasive interventional procedures, radiation
therapy or therapy monitoring. Radiology
departments today are faced with many
challenges to improve operational efficiency,
performance, and quality to keep pace with rapid
transition in the healthcare delivery.
In the last two decades, the field of medical
imaging has benefited greatly from extraordinary
technological advances. The introduction of
imaging modalities such as CT and MRI has
brought the biggest breakthrough in imaging
science since the discovery of X-rays more than
100 years ago. Radiology has transformed from
static imaging to a more dynamic diagnostic tool
that is able to characterise abnormalities even on
metabolic, cellular and molecular levels. Medical
imaging plays a critical role in establishing the
diagnoses for innumerable conditions and it is
used routinely in nearly every branch of
medicine, thereby playing a key role in disease
management. Accordingly, the duty and workload
of the radiologist has changed rapidly in the last
decades; the time when a radiologist analysed
‘just a film’ are long gone. Technological advances
in the field of radiology, rapidly developing
therapeutic innovations, demographic shift,
changing lifestyle of modern society and a rising
number of chronic conditions are influencing the
exponential increase of the use of medical
imaging. Instead of a single X-ray film, a CT exam
of the chest, for example, comprises at least 300
slices, each of which are evaluated by a
radiologist on a regular basis. MRI exams are
much more complex, depending on the number
of sequences acquired, and not to mention
complex image-reconstruction procedures which
are increasingly required. The flip side of the coin
entails however, unwanted consequences such as
increased workload, shortage of imaging
specialists, and less time available for interpreting
and communicating the imaging exams with
patients and referring clinicians. The main
challenge the field of radiology is facing
nowadays is to handle an ever-increasing