IDNs are challenged by operational, technical, and clinical constraints that must be orchestrated
Consolidating regional Integrated Delivery Networks (IDNs) are striving to deliver continuous, transparent, and reliable quality of care across their service lines. As states are being covered by fewer and larger competing IDNs, health systems want to leverage their scale and distributed clinical resources to ensure easier access, higher quality, and better value of care. In order to deliver predictable service levels and higher value in radiology, there are numerous operational, technical, and clinical constraints that must be orchestrated.
Ongoing consolidation of the U.S. hospital landscape will lead to 400 and 600 different hospital organization, down from the current 1,600.1
In 2017, several hundred hospitals still operate as stand-alone hospitals in the U.S., but very large networks will soon prevail. 1
Ongoing consolidation of the US hospital landscape
Today several hundred hospitals still operate on a stand-alone basis, while at the opposite end of the spectrum, only a few very large multi-site systems with several dozens of hospital facilities exist. Soon, these very large networks will prevail, with some spanning state-wide or crossing state borders, such that all in all the U.S. will be left with between 400 and 600 different hospital organizations, down from the current 1,600.1
The need of IDNs: Service line solutions
Driven by the need to reduce costs and reap higher value from the system, the ongoing consolidation of hospitals into large IDNs and healthcare systems presents a series of challenges for the IDN: imaging is ordered incorrectly, patients leave the system for care, and disparate systems spread across various locations using multiple EHRs do not communicate. IDNs need solutions to help optimize quality, productivity, and increase market share deliver seamless, appropriate, and evidence-based care.
How should a service line solution work from a patient’s point of view?
Find out more in the story of Laura
$18,6M total revenue increase from 4 imaging service lines commercialization items over 18-30 months1
Two organic growth opportunities through increased out-of-network referrals and minimized network leakage.1
Two external growth opportunities through tele-imaging activities and expanded catchment area.1
Service lines to fuel growth in a consolidating healthcare market
The future of radiology within IDNs lies in service lines that share common operating objectives with the organization, rather than the current siloed hospital imaging departments. IDNs must work in concert with their employed or partner radiologists to enhance productivity and efficiency. An imaging service line requires seamless integration of professional and technical imaging resources, as part of the IDN’s operating plan, in order to ensure alignment and success.1
Can you ensure that the right study is read by the right radiologist for the right reason?
Consolidation into IDNs leads to variability of care resulting from their disparate sites, practices, and IT platforms.
With Medicalis Workflow Orchestrator3 we enable you to organize, optimize, and orchestrate radiologist readings across disparate sites, radiology practices, and IT platforms. The solution provides a Workflow Orchestration layer for the radiologists, offering a single workflow across the IDN to increase radiologist productivity and efficiency, while producing a single-integrated platform to reduce variation in care and improve the quality of patient care across the IDN service line.
Workflow orchestration supports the ability to load balance, based on criteria such as sub-specialty, SLA, and operating plan goals to ensure a strategic alignment between IDNs and radiologists.
Benefit from a single access point that enables even remote reading by the most appropriate radiologist, regardless of their physical location – to improve diagnostic accuracy
Normalize, optimize and standardize information from multiple IT systems on a single integrated platform – to reduce unwarranted variations
Auto-assign exams to the right radiologists through workload balancing capabilities – to increase workforce productivity and efficiency
“Medicalis has greatly benefited UCLA and its patient population by providing innovation and agility that can’t be understated. We depend on them to provide solutions that adapt to a constantly changing landscape of regulations and reimbursement. I take great comfort in knowing that our relationship is deep and enduring.” 4
Edward J. Zaragoza, MD
Chief of Radiology Informatics, Clinical Professor
UCLA Radiology at University of California, Los Angeles, U.S.
What is your community engagement strategy to promote growth? Do you find yourself vulnerable to network leakage?
The current challenge for fast-growing regional IDNs is leakage from their network. Patients who aren’t informed of their provider choices and who don’t have an easy way to schedule appointments with these providers are likely to seek services outside the IDN. This not only results in revenue loss for the IDN, it also causes a disruption in care for the patient. Referring providers and specialists also need enhanced communications capabilities with patients as well as peer-to-peer communication in order to maintain and grow the IDN.
The solution: a referral management platform
With Medicalis Referral Management3, we deliver an enterprise integrated imaging referral management solution, which optimizes the use of IDN resources and personalizes the availability and delivery of care to patients. Empowering you to effectively promote your providers, while complimenting your host EHRs, and connects patients with the most optimal physicians.
How a referral management program impacts 4 key stakeholders: your health system, patients, clinicians and referrals
Drive growth and reduce leakage by making your services more visible and available to your referring community
Improves patient access to care because the most appropriate specialist is assigned to cases through aggregated views into disparate scheduling systems
Optimizes clinical pathways between departments and facilitates communication between the providers and specialists
Clinical Decision Support
How can you you ensure that the most appropriate imaging exams are ordered for your patients? With the ongoing transition in healthcare to value-based care, healthcare providers want to achieve better outcomes while at the same time lower costs. A way to achieve this is to implement clinical decision support. This approach leads to improved patient care, by using evidence based Appropriate Use Criteria at the point of care to improve radiology ordering.
Clinical decision support is critical to the success of the IDN, as up to 26% of all imaging is ordered incorrectly when evidence-based standards are not in place.2
The solution: Leveraging a clinical decision support solution to drive appropriateness in imaging. Enhancing the quality of indications capture, aligned with evidence and best practice, driving to the “Right Order First Time”. While reducing waste, delays in care, and improving Physician to Physician communication. The Medicalis Clinical Decision Support3 Mechanism provides a proven, evidence- based targeted approach focusing on specific modality, indication and clinical area aligning with the Priority Clinical Areas (PCAs) for content delivery.
Qualified Clinical Decision Support mechanisms as of November 2017
Medicalis Clinical Decision Support has been confirmed as a qualified clinical decision support mechanism (CDSM) by the Centers for Medicare and Medicaid Services (CMS) under the Medicare Appropriate Use Criteria (AUC) program for advanced diagnostic imaging, and it has received full qualification.
Driving the “Right Order First Time”
- Augment the Physician’s workflow with focused structured indication capture
- Decrease alert fatigue and improve clinical relevance, while safely moving work away from Physicians
- EHR embedded workflows
- Meet the PAMA CDS Mandate
“By utilizing Medicalis technology integrated with our enterprise EHR, Weill Cornell Imaging hasn’t just optimized its current safety and operational workflows, it’s also well positioned for further reimbursement, regulatory, and operational requirements.” 4
Keith Hentel, MD, MS
Executive Vice Chairman, Vice Chairman for Clinical Operations,
Associate Professor of Clinical Radiology at Weill Cornell Medicine,
Department of Radiology New York Presbyterian Hospital. U.S.
1Source: Frost & Sullivan Brief: Fuel Growth in Imaging, Nov 2017, by Nadim Michel Daher, Industry Principal, Medical Imaging and Imaging Informatics
2Source: https://innovation.cms.gov/Files/reports/MedicareImagingDemoEvalRTC.pdf, page 51
3Medicalis Workflow Orchestrator, Medicalis Referral Management, and Medicalis Clinical Decision Support are available in the U.S. only. The products mentioned herein are not commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details.
4The statements by customers of Siemens Healthineers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption), there can be no guarantee that other customers will achieve the same results.