Mercy San Juan Medical Center is a 370-bed acute-care hospital in Carmichael, California, that is part of the not-for-profit Dignity Health System. It has experienced significant growth since it opened its doors in 1967—particularly following the 2009 introduction of a new patient tower that added 110 beds.

Radiologist efficiency has increased by leaps and bounds in the digital era, but reimbursement trends have kept steady the pressure to improve productivity further. A handful of emerging tools for the practice potentially could make already-productive physicians even more efficient, according to Bill Pickart, CEO of Integrated Medical Partners (IMP); Pickart says, however, that these tools will represent a cultural shift that will need to be managed skillfully for maximum effectiveness.

Influenced by emerging technology and regulatory changes, the role of the radiology-group CIO has undergone a dramatic shift in recent years: Wayne Davidson, CIO of Quantum Imaging & Therapeutic Associates, Inc (Lewisberry, Pennsylvania), a 40-radiologist practice, says, “In recent years, the focus has really become efficiency because of background factors like declining reimbursement. That drives the business to try to do more with less, and that goal is laid on the shoulders of the IT department.

Quantum Imaging & Therapeutic Associates, Inc, a 40-radiologist practice in Lewisberry, Pennsylvania, faced a problem common to radiology groups in the post-DRA era: improving efficiency without decreasing the quality of its interpretations. Elizabeth Bergey, MD, CEO of the group, says, “Radiologist efficiency and efficacy are based, somewhat, on internal factors. Everybody has his or her own personal work ethic, and in any population, there will be some variation.

The topic of efficiency in radiology is both politically and emotionally charged. Improvements in radiologists’ productivity are increasingly critical to financial viability, but cannot be achieved at the expense of clinical quality, especially at a time when quality will be increasingly closely linked to reimbursement. Further, any radiology group that begins tracking (or even providing incentives for) efficiency risks an uphill battle, in terms of changing the culture of its business.

Since opening on February 17, 1910, the 375-bed Children’s Hospital Colorado (CHC), in Aurora has tried to be a leader in providing the best health-care outcomes for children.

Many radiology administrators remember purchasing their first or second PACS: It was probably no small financial commitment, and justifying the expense might have been a painful process.

When Duke University Health System (DUHS) in Durham, North Carolina, goes live with its full-blown Epic electronic health record (EHR) implementation in June 2013