"We've got to get radiologists out of the basement" onto the "care floor" of hospitals, such as having radiologists consult regularly with other physicians and patients, "making sure the right tests are being performed," says Neal.
Indeed, Weiss and Neal say there have been too many errors, too much clinical variation, and too much costly duplication of work among radiologists. They say it's important that providers and hospitals adopt system level standards and best practices for radiologists to improve efficiency and quality.
By establishing measurable performance standards to evaluate and ensure accountability among providers, radiology programs can be markedly improved, according to Weiss and Neal. There are tough tasks to overcome. Lack of coordination to improve workflow and costly turnaround times impact the complete care cycle, especially the emergency departments.
Through these standards-based approaches, hospital officials can reduce overutilization. Radisphere estimates that studies show about 20 to 50% of inpatient diagnostic imaging may be clinically unnecessary, driven by referring physicians and radiologists.
Unnecessary imaging can occur when "a wrong exam is being ordered to begin with, or a radiologist can't get a 'clean' read, Neal says. "There is a big variation that frequently has tremendous downstream implications" for costs and quality, he says.