The aggregation and utilization of data in health care has two sides, according to Lynn Gibson, vice president and CTO of Christus Health, Irving, California. The first, and most in focus, is the provider’s; the second, less emphasized but equally important, is the patient’s. “Health care is on a rapidly changing path,” he says, “and data-driven analysis is necessary for both the caregiver and the patient. We have to be able to collect the pertinent information to support both sides and make it available to both the patient and the clinician.”

Successful health-care organizations will reengineer both their structure and processes as reimbursement shifts towards managing populations, and measurements are required to both support this transition and document its value, according to Jake Nunn. Radiology’s diagnostic role in the continuum of care provides a unique opportunity for participation in this transition, he says.

In a February 2013 article for JACR: The Journal of the American College of Radiology entitled “Culture Shift: An Imperative for Future Survival,” Lawrence R. Muroff, MD, CEO of Imaging Consultants Inc, outlined how radiology’s culture needs to evolve to meet the changing demands of US health care. “I think the overwhelming majority of radiology groups believe that what has worked for them in the past will continue to work—that if they just stay the course, they’ll be fine,” Muroff says. “Most groups don’t respond to change until something dramatic happens, at which point the pain of maintaining the status quo exceeds the pain of changing.”

Patient engagement in health care (or patient-centered communication, as it’s often called) has been compared to marriage, where the relationship between care seeker and caregiver is based on trust, respect, openness, and empowerment.

A decade after starting Diagnostic Professionals, Inc (DPI), Claude Hanuschak, its COO, still refuses to let federal payment policy thwart his success. When faced with a 35% reimbursement reduction due to implementation of the DRA, the 30-year radiology veteran and president/COO of the four-site Florida imaging-center chain responded with a resolve to become more efficient, largely through a reliance on appropriate technology.

If the triple aim—improved access to better-quality health care at a lower cost—is the goal of health-care reform, then patient-centered care is its soul. Throughout the Patient Protection and Affordable Care Act, the authors took precautions to protect patients from the abuses of 1990s-era managed care, when profits appeared to trump patient care.

Orthopedic practices are no strangers to pursuing optimum patient satisfaction with imaging as part of a growth strategy; in fact, their growth is often dependent on it. Dale Ingram, CEO of the Cardinal Orthopaedic Institute (COI), Columbus, Ohio, says, “Of our MRI patients, 98% came from within our practice—we get very few patients from outside referrals. Imaging plays a big role in whether patients are satisfied with our service. They don’t have to go somewhere else and re-register, and it also helps with their continuity of care—our radiologists are here in the building and can talk to our physicians at any time. Every aspect of the process is easier for patients.”

Whether given incentives by the continued cuts in reimbursement levels or by the desire to monetize an operating asset, radiologists in the market continue to sell their imaging centers to buyers of many kinds—for-profit imaging-center owner/operators, for-profit hospitals/health systems, and not-for-profit hospitals/health systems, among others. Although the sale of the imaging center transfers all (or a portion of) the ownership to the buyer, there are still opportunities for radiologists to remain involved in the business. Specifically, many radiologists continue to provide exam interpretations and/or specific management services.