After COVID-19, Radiology to Rethink Revenue Cycle Management

After COVID-19, Radiology to Rethink Revenue Cycle Management | blog article by Catalina Imaging

With no end in sight of the pandemic, some radiology clinics need to rethink their practices to better their revenue cycle management and improve their services to stay afloat. 

 

COVID-19 has far-reaching effects more than anyone ever expected. A report, conducted by lead author Richard Sharpe Jr., MD, MBA, a radiologist with the Mayo Clinic, and colleagues about the impact of COVID-19 on radiology, stated, “Some groups may prove unable to survive the COVID-19 pandemic, potentially fueling trends either toward consolidation into larger radiology groups or toward increased employment by hospitals.” 

 

In the first six months of the pandemic, records show a steady decrease in the revenues of many radiology practices. For some, the percentage of this decline reached up to 80%. Most affected by this situation are the smaller private practices whose revenues are dependent on examination interpretation. 

 

Some cost-cutting measures were already adopted by others in the industry, including salary diminution, time off, and reduction of benefits. While these actions worked to keep practices afloat, experts do not consider this viable solution in the long term. They predict that smaller practices will be likely consolidated with larger groups that offer a broader practice model. 

 

The industry remains hopeful as lockdowns are lifted, and communities are reopened, but just like for any other industry, a consistent decrease in revenue remains imminent for some. 

 

According to an Urban Institute estimate, about 10 million people will lose their healthcare coverage from a COVID-19-related job loss. People who previously relied on employer-sponsored health cards are projected to switch to healthcare coverage through other family members as dependent or enroll in Medicaid. Radiology practices will most likely see a rise in Medicaid and self-paying patients.  

 

The COVID-19 pandemic continues to batter a lot of industries. Those who cannot transform and reinvent themselves are at a higher risk of losing the battle. 

 

For radiology practices, one point must be highlighted: Patient care is a top priority. Practitioners must deliver client-focused patient care and ensure hassle-free visits to attract more self-paying patients. An over-all pleasant medical procedure will boost the confidence of patients in smaller radiology practices. Hiring highly-qualified staff also guarantees the quality of healthcare provided. 

 

Another highly suggested way for radiology practices to survive is to adopt new technologies and better processes to offset lost revenue opportunities. Investing in technology, streamlining workforces, improving bill cycles are a great start.

Getting a partner to optimize billing and introduce automation is a thing to consider as well. Howard Pingston, Regional VP of Business Development in Radiology with Zotec Partners, stated that “Radiology groups will not only face an increase in bad debt but also potentially an 8 to 11 percent reduction in reimbursement in 2021, depending on the CMS final ruling. Now more than ever, radiology practices need an RCM partner that is truly equipped to help them identify revenue opportunities and provide full transparency throughout the process in order to weather this storm in the near term and succeed in the long term.” 

 

The availability of convenient payment options is also a plus factor. Online payment and special discounts are also appreciated by people who are struggling in this time of pandemic and economic recession. 

 

The answer to the problem faced by radiology practices requires a multi-pronged approach. It is a combination of technological, financial, and personal solutions.  COVID-19 is a difficult enemy that everyone wants to get rid of. While the battle is far from over, it pays to prepare and soldier on constantly. 

Use of A.I. in Radiology Showing Positive Benefits to the Community

A Glimpse into the Future: How AI Technology Will Affect Radiology | blog article by Catalina Imaging

Yale New Haven Health System (YNHHS) has implemented an AI-powered system to optimize radiology practice in real-time collaboration and data organization.

Historically, radiology has had a crucial and active role in the evolution of healthcare. Radiology’s role in the current COVID-19 crisis is undoubtedly critical for its prevention and cure for the patients. 

The healthcare system worldwide, including radiologists, is facing a never before experienced exhaustion and financial constraints since the virus has spread. Nobody was ever truly ready for it.

Now, more than ever, radiology should adapt to the ever-changing world and technological advancements to avoid specialist burnouts and backlogs. 

A new age has dawned at Yale New Haven Health System as it fully embraces and AI-powered technology called PowerScribe Workflow Orchestration and PowerConnect Communicator to improve efficiency and promote safe practices in the facility.

Yale School of Medicine’s Dr. Irena Tocino, MD, FACR, professor of radiology and biomedical imaging and vice-chair of imaging informatics shared how the AI-based system has improved their workflow and efficiency, “Studies are analyzed first by the AI model. Positive results are automatically prioritized on the appropriate worklist, while negative results move down the list for later review. Having this solution in place helped YNHHS navigate the challenges because of the pandemic – from an influx of COVID-19 patients to the swift transition to remote reading.”

“YNHHS has transformed their reading room experience, keeping colleagues connected, more efficient, and safer in a virtual paradigm, while prioritizing patient care.”

The technology in place has forged a new path in helping the medical frontliners work smarter, not harder — allowing them to focus on analyzing efforts rather than organizing data. Real-time, remote collaborations optimized data analysis, making way for efficient application of healthcare. 

In these trying times, the PowerScribe Workflow Orchestration and PowerConnect Communicator is a promising technology that can unload the burden of the already burnout healthcare system if properly implemented.

Covid-19 Affects Non-White Patients More Severely, According to Study

Covid-19 Affects Non-White Patients More Severely, According to Study | Catalina Imaging

In a recent study, it has been found that non-white, Covid-19 patients, are more likely to develop more severe cases of the illness. According to radiologist Dr. Efren J. Flores, co-founder of the study, who works at the Massachusetts General Hospital, “It got to the point where half of our patient population admitted with COVID-19 were underrepresented minorities [in our local population].”

After analyzing data from 326 Covid-19 patients and examining their chest X-Rays, the result became clear: non-white patients coming from lower socioeconomic groups were more likely to be put in ICUs and die.

There is a multitude of reasons that contribute to this phenomenon. On its own, the virus can affect anyone. António Guterres, the secretary-general of the United Nations, said, “The virus does not discriminate, but its impacts do, exposing deep weaknesses in the delivery of public services and structural inequalities that impede access to them.”

It leaves the people with low-wage jobs more prone to severe cases of the disease because they have limited sick leaves and health care benefits from their employers. The authors of the study pointed out that Blacks, Hispanics, and people from other ethnic minorities were more likely to have these kinds of jobs. Dr. Flores noted that these people tend to refrain from going to the hospital, due to the fact that they live on a weekly paycheck and have other dependents.

The authors also observed that the patients in these groups usually live in overcrowded, high-density urban areas that make social distancing more difficult.

Another underlying socioeconomic factor that the authors have found is limited English proficiency. As the new health information regarding Covid-19 was only available in English during the first few months, non-English-speaking individuals had trouble going through the complex medical system.

Lastly, the institutional racism that many of these people have previously experienced resulted in distrust in the medical system. It leads to them not seeking care until the disease becomes severe.

These healthcare problems experienced by the non-white people have already been present way before the pandemic, but the situation exposed and amplified them further.

Source: Medical News Today

Top Radiology Groups Team Up For ‘Massive’ COVID-19 Imaging Database

Top Radiology Groups Team Up For ‘Massive’ COVID-19 Imaging Database | Catalina Imaging

Top radiology experts are working together to develop the Medical Imaging and Data Resource Center (MIDRC) — an extensive, open-source medical image database of COVID-19 patients to help in the ongoing battle against the virus.

The massive public-private project partnership is funded under the National Institute of Health’s special COVID-19 emergency response through a contract with the University of Chicago and in collaboration with major radiology networks; The American College of Radiology, Radiological Society of North America, and American Association of Physicists.

Dr. Etta Pisano, ASR Chief Research Officer said in the announcement that, “The MIDRC database will provide a critical tool to help the medical imaging community, doctors and scientists better understand COVID-19 and its biological effects on humans. This knowledge, and the technological advancements the registry can enable, will ultimately help providers save lives,”

Aside from leading radiologists, top engineers, physicians, and scientists join the project’s pool of experts to collect and organize the data using artificial intelligence (AI) algorithms. This strategy is implemented to improve the accuracy and speed of handling more than 10,000 COVID thoracic x-rays and CT images.

As a result, radiologists can focus on analyzing the medical images from COVID-19 patients. The scans play a vital role in determining the severity of the virus and prescribing an optimal and individualized treatment for a patient.

The project also includes five infrastructure developments and supervision of twelve research studies, including 20 university-run laboratories, to find solutions to the coronavirus pandemic.

The MIDRC provides a rich and accessible resource of scans and clinical data for medical professionals and researchers worldwide.

The American Association of Physicists in Medicine (AAPM) research committee chair and a faculty of the University of Washington, Dr. Paul Kinahan, said that they are initially focusing on COVID-19 but the network has plans to expand imaging data and AI tools to existing and future healthcare threats.

Sources

  1. HealthImaging.com
  2. RSNA.org

Canon Medical Launches CT Solution in Answer to COVID-19

Canon Medical Launches CT Solution in Answer to COVID-19 | Catalina Imaging

Last April 29, Canon Medical Systems USA, Inc, launched “deployable CT solutions and rapid decontamination” to help hospitals that are screening and caring for patients suspected to be positive or confirmed to be infected with COVID-19.

This may also be helpful in the isolation and imaging of patients who may be suffering from other viral infectious diseases.

Completely Capable System

This new deployable system involves the Aquilion Prime SP. This CT system offers the following benefits, among many others:
● Hit multiple anatomical areas within one breath-hold and one contrast injection
● Give healthcare workers access to the patient from the front and rear of the gantry
● Can be installed in most existing CT rooms

According to Canon Medical, the Aquilion Prime SP system “can generate 160 unique slices per rotation with 0.35-second scanning, reducing the time required to perform studies for compromised patients, and also increase throughput.” This makes the system useful even in emergency cases.

In Canon Medical’s new offering, the Aquilion Prime SP CT system can be used in a modular or mobile footprint with a rapid decontamination tool. This assures rapid imaging, safe handling of patients, complete isolation (even from other hospital staff), and necessary decontamination.

Cleaning and Decontamination in Minutes

According to Diagnostic Imaging in an article written by Whitney J. Palmer, “In most cases, based on industry guidance, a CT scanner has been decommissioned for roughly an hour between scanning patients to minimize the likelihood of viral transmission.”

An hour can already be the length of a church service. If we recall the story of Patient 31, after she attended two services at her church in South Korea, she ended up infecting 1,160 people as of March 20.

Hospitals and healthcare workers do not have the luxury of an hour to make sure their CT scanner is ready for another patient — not in a time like now with its demands.

Rapid UV-C Decontamination

Canon Medical addresses this with its system that can be decontaminated in minutes, with the use of an automated ultraviolet light system. “Imaging infectious disease patients is not a new phenomenon for medical providers,” said Erin Angel, managing director, CT Business Unit, Canon Medical Systems USA, Inc, in a statement.

“But our customers are facing an unprecedented number of potentially contagious patients,” he continued. “Our deployable CT offerings with the addition of rapid UV-C decontamination will offer providers a unique solution to help improve their workflow and safety as they image infectious disease patients.”

Least Chances of Contamination

Simply put, Canon Medical’s decontamination system is an automated UV-C technology that significantly reduces bacteria, spores, and viruses. It is effective against a variety of advanced viral infectious diseases. It is readily available for new CT solutions as well as existing imaging suites.

The system’s multiple automated UV-C emitters work together to provide decontamination of the room in minutes, a big factor especially with a virus as quick to spread as SARS-CoV-2 (this is the official name that the World Health Organization gave the coronavirus or the virus that causes COVID-19).

Are CT Scanners Useful in Diagnosing COVID-19?

Are CT Scanners Useful in Diagnosing COVID-19? | Catalina Imaging

Recent literature in radiology suggests that CT scanners may play an important role in the diagnosis of COVID-19.

In a recent article published in The Lancet, a team of researchers has observed that almost all of the confirmed COVID-19 cases under their care also had CT findings of pneumonia.

These medical researchers, working with coronavirus patients in Wuhan, China, have found that 97% of their 1,014 patients with RT-PCR-confirmed diagnoses also had observed lung opacities on CT— a notable manifestation of pneumonia. In their report, the medical researchers have concluded that “CT imaging has high sensitivity for diagnosis of COVID-19”.

This is particularly welcome news, especially with shortages of real-time RT-PCR (reverse transcription-polymerase chain reaction), so far one of the most effective and accurate laboratory methods for detecting, tracking, and studying the coronavirus.

Further Investigation Needed

Meanwhile, another group of researchers has had less optimistic observations.

A team that had reviewed the CT scans of 112 cases of RT-PCR-confirmed COVID-19 from the Diamond Princess cruise ship reported that only 61%– or less than two-thirds– of cases exhibited pneumonia. Furthermore, 20% of symptomatic patients had negative CTs.

So while CT scans do show promise in the diagnosis of COVID-19, these results should not be overstated, cautioned The Lancet.

“The CT findings studied (e.g., ground-glass opacity, consolidation, etc.) are not specific for COVID-19. Similar results would probably be found if CT were used during an influenza epidemic, for example.”

Bringing A.I. Into The Picture

Meanwhile, a medical devices company based in Huizhou, China is exploring the possibility of using an AI-powered imaging solution to aid in the detection of COVID-19

Huiying Medical, a member of Intel’s AI Builders program, claims to have developed the solution’s underpinning algorithms based on data from CT chest scans from over 4,000 coronavirus cases.

Huiying’s solution analyzes what’s known as ground-glass opacity (GGO) in the lungs, which indicates a partial filling of air spaces, as well as other indicators that inform a probability of suspected COVID-19 infection.

Huiying asserts that its solution should be useful in regions of the world without access to real-time RT-PCR. It only takes a day to install and only 2-3 seconds to process CT studies with 500 images.

Moreover, it has a claimed 96% novel coronavirus pneumonia (NCP) classification rate, and it’s designed to work either in the cloud or on-premises.

Through a partnership with Huawei, Huiying has already reached out to many other health professionals and institutions. The new AI-enabled imaging solution is now being used in over 20 hospitals, including those in Ecuador and in the Philippines.

Promising, But Needs More Work

The Lancet stresses that, despite its limitations, RT-PCR is still the accepted standard and only positive in patients who are infected with severe acute respiratory syndrome coronavirus 2.

While advancements in CT technology and research shows promise, the medical journal cautions using published guidelines regarding the use of CT imaging– at least for now.

CT findings in patients with COVID-19 are seen with numerous pathogens and in many non-infectious aetiologies. “Using CT diagnostically is not known to provide clinical benefit and could lead to false security if results are negative,” warns Michael Hope of The Lancet.

“If COVID-19 is suspected, patients should be isolated pending confirmation with (multiple) RT-PCR tests,” he stressed, “or until quarantine has lapsed. The results of a CT scan do not change this.”

Recommendations From The CDC and the ACR

Currently, the Center for Disease Control (CDC) does not currently recommend CXR (chest radiographs) or CT to diagnose COVID-19.

The American College of Radiology (ACR) has its own supporting recommendations for the use of computed tomography (CT) and chest radiography for suspected COVID-19 infections.

Even if radiologic findings are suggestive of COVID-19 on CT, confirmation with the viral test is still required. As such, viral testing remains the only specific method of diagnosis.

In the meantime, until more widespread COVID-19 testing is available, some medical practices are requesting chest CT to inform decisions on whether to test a patient for COVID-19, admit a patient or provide other treatment as an interim measure.

As such, facilities may consider deploying portable radiography units in ambulatory care facilities for use when CXRs are considered medically necessary. The surfaces of these machines can be easily cleaned, avoiding the need to bring patients into radiography rooms.

While locally constrained resources may be a factor in decision making, a normal CT should not dissuade a patient from being quarantined or provided other clinically indicated treatment when otherwise medically appropriate.

Mobile CT Scanners By Catalina Imaging

Catalina Imaging is committed to providing the highest quality solutions by specializing in mobile CT scanners using state-of-the-art Siemens, GE, and Toshiba/Canon technology.

The CT scanners we use in our trailers are the best available from GE, Toshiba, and Siemens. Depending on your needs you’ll receive GE’s Lightspeed VCT64 with ASiR, Toshiba’s Aquilion 16 MultiSlice Computerized Tomography Scanner, or one of our Siemens mobile CT units.

For details and more information about our mobile CT scanners, give our Catalina Imaging team a call today at (844) 949-1664.

Sources

  1. The Lancet
  2. The International Atomic Energy Agency
  3. Venture Beat
  4. American College of Radiologists