Clinical analytics for radiology practices, in its current form, is defined by nothing so much as its limitations, according to Benjamin Strong, MD, CMO of Virtual Radiologic (vRad). “Practices don’t have the kinds of actionable insights they should, in terms of study characteristics, study mix, referring patterns, workflow, RVUs, and so on,” Strong says. “It’s something with which practices are struggling, if they’re even aware that they don’t have the analytics they need. We were managing blind during the good old days, and that continued for so long that many people don’t even miss analytics.”

On July 16, CMS announced the results1 of its accountable-care organization (ACO) program, the Pioneer ACO Model. The program was designed to test the impact of higher levels of shared savings and risk on ACO success, and it attracted 32 participants from around the country. After the first year of participation, seven Pioneer ACOs that did not produce shared savings announced their intention to transition to the lower-risk (and lower-reward) Medicare Shared Savings Program, while two dropped out of the ACO model entirely.

Few would disagree that it’s increasingly difficult to operate as a freestanding imaging-service provider. Reimbursement continues to face pressure, patients have become more savvy regarding their copayments, and increased competition from hospital operators has caused industry participants to become intensely focused on cost efficiencies. We have entered an environment where economies of scale and focused expertise will correlate with enhanced competitive advantages; consequently, we find evidence of increased partnerships and consolidations. One factor that stands to accelerate the partnership/consolidation trend is often left out of the conversation: The impact of the recession on capital investment in imaging equipment might soon create accelerated market activity, however.

Every business starts somewhere; even in the current period of radiology-practice consolidation, startups are popping up around the country. David Myrice, director of practice management for Medical Management Professionals (MMP), says, “Every so often, an opportunity still presents itself to form a new group.

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.