When outpatient imaging center Ocean Radiology (New York, New York) opened its doors in South Brooklyn, seven years ago, the intention of Steven Polk, founder and owner, was to offer an unparalleled imaging service to the community. “We differentiated ourselves from the other imaging providers in the area by going with high-end equipment (which wasn’t common, around here) and with sophisticated studies that weren’t being done at the time,” Polk recalls. “The nearest hospital is an hour’s trip away, and having a study done there could take all day. We’re close to our patients’ homes, convenient, fast, and high quality.”

In the wake of the Cedars-Sinai CT overexposure scandal, California passed legislation in 2012 mandating the monitoring and reporting of CT-exam radiation dose; since then, dose-monitoring legislation has passed (or is being considered) in multiple states, and public awareness of radiation risk has been significantly heightened. Ian Judd, product manager for Sectra, says, “There’s been a lot of media attention in the United States, and in Europe as well. Due to instant access to information on the Internet, people are far more aware that radiation is a bad thing. What they haven’t been made aware of is that it’s a good thing, when used correctly.”

Disaster recovery is an event that PACS administrators hope that they never will have to confront, but it is increasingly clear that it needs to be a top-of-mind concern. Natural disasters, particularly tornadoes and floods, seem to be occurring more frequently, with greater intensity and with more resulting damage. Hospitals and imaging centers are not exempt from their effects.

With more than 800 active health IT applications to maintain, Bill Russell has no time for distractions. The senior vice president and CIO of St Joseph Health—a nonprofit integrated health-care network that includes 14 hospitals in California and Texas—has a lot on his plate.

After four days of ravaging Jamaica, Cuba, and the Bahamas, Hurricane Sandy slammed into the New Jersey shoreline on October 29, 2012, resulting in losses of $30 billion to businesses in the affected area; damaging or destroying 346,000 homes; causing widespread power outages (some of which lasted for several weeks); and killing 37 people. Neither the popular seaside city of Cape May nor Cape Regional Medical Center (CRMC), a 240-bed community hospital in Cape May Court House, suffered damage from what turned out to be the deadliest, most destructive hurricane of the 2012 Atlantic hurricane season—and the second-costliest storm of its type in U.S. history.

Eisenhower Radiology Medical Group (ERMG) has accomplished what many would consider impossible: rapid, recent expansion during a recession, with a patient base composed primarily of Medicare beneficiaries. The 17-radiologist group, located in Rancho Mirage, California, has added three imaging centers to its roster in as many years, according to Blair Dick, business administrator for the practice. “One of the biggest challenges we’ve faced was expanding from one facility to four in this economic environment, which is one of the worst we’ve ever faced,” Dick says. “We did it because we wanted to position ourselves to accommodate the increased demand for imaging services that will result from health-care reform.”

The proposed 2014 Medicare Physician Fee Schedule1 (MPFS) and Hospital Outpatient Prospective Payment System2 (HOPPS) rules have both been released, and the outlook for radiology is dim, according to Cynthia Moran, assistant executive director for government relations and economics at the ACR®. “The only good news—if you can call it that—is that CMS no longer appears to be targeting only radiology,” Moran says. “It used to be that it was seeking to take from the specialties and give back to primary care, but now, it’s not even doing that. It’s just lowering how much money is spent as much as it can.”

Radiology-practice consolidation has become more than just a trend: It’s an imperative for future survival, according to Michael Brant-Zawadzki, MD, Ron and Sandi Simon endowed executive medical director chair at the Hoag Neurosciences Institute (Newport Beach, California). “Scale is becoming much more important,” he notes. “Smaller groups are looking for help and are being overtaken by corporate entities like national teleradiology groups—or by larger, independent group practices. Under that model, they can distribute subspecialty services more efficiently and can realize economies of scale.”