UCLA, Los Angeles, CA, USA.
J Am Coll Radiol. 2012 Oct;9(10):713-7. doi: 10.1016/j.jacr.2012.06.022.
Because radiology has historically not measured its added value to patient care and thus not communicated it in easily understood terms to all stakeholders, the specialty must correct this to prepare for the eventual transition from the current fee-for-service payment schedule to new value-based reimbursement systems. Given the increasing risk for marginalization, radiologists need to engage clinicians and managers to map the processes and associated costs of episodes of patient care to identify areas for providing and improving integrated diagnostic information and to measure the value thereof. In such time-driven, activity-based costing practices, radiologists should highlight how proper investments in the information generated by imaging and how radiologists' associated consultative and coordination of services can save greater resources downstream, especially in the nonrenewable resource of physician time, an increasingly scarce health care resource. Using physician time in the most efficient way will be a key element for decreasing health care costs at the aggregate level. Therefore, expressing radiology's contribution in terms of downstream physician time saved is a metric that can be easily understood by all stakeholders. In a conceptual framework centered on value, the specialty of radiology must focus more on its most important product, actionable information, rather than on imaging technologies themselves. Information, unlike imaging technologies, does not depreciate with time but rather increases in value the more it is used.
由于放射科在历史上并未衡量其对患者护理的附加值,也未能以易于理解的术语向所有利益相关者传达这一信息,因此该专业必须纠正这一问题,为从当前按服务收费的支付模式向新的基于价值的报销系统的最终过渡做好准备。鉴于放射科面临边缘化的风险越来越大,放射科医生需要与临床医生和管理人员合作,对患者护理事件的流程和相关成本进行映射,以确定提供和改进综合诊断信息的领域,并衡量其价值。在这种基于时间的、基于活动的成本核算实践中,放射科医生应该强调对成像产生的信息进行适当投资,以及放射科医生的咨询和服务协调如何可以在下游节省更多资源,特别是在医师时间这一不可再生的医疗资源上,医师时间是一种日益稀缺的医疗资源。以最有效的方式利用医师时间将是降低总体医疗成本的一个关键因素。因此,用节省下来的下游医师时间来表示放射科的贡献,是一种所有利益相关者都能轻易理解的衡量标准。在以价值为中心的概念框架中,放射科专业必须更加关注其最重要的产品,即可操作的信息,而不是成像技术本身。信息与成像技术不同,它不会随着时间的推移而贬值,而是随着使用次数的增加而增值。