Shaikh Faiq, Hendrata Kenneth, Kolowitz Brian, Awan Omer, Shrestha Rasu, Deible Christopher
UPMC Enterprises, Pittsburgh, PA, USA.
Temple University, Philadelphia, PA, USA.
J Digit Imaging. 2017 Jun;30(3):267-274. doi: 10.1007/s10278-016-9940-7.
In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study. These new dimensions of value measurement will directly impact the cascade of further medical management. We share our continued experience with this project that had two components: RESP (Referrer Evaluation System Pilot) and FRACI (Feedback from Radiologist Addressing Confounding Issues), which were introduced to the clinical radiology workflow in order to capture referrer-based and radiologist-based feedback on radiology reporting. We also share our insight into the principles of design thinking as applied in its planning and execution.
在基于价值的医疗时代,医疗护理的许多方面都在被衡量和评估,以提高质量并降低成本。放射学在医疗保健成本中占比巨大,因此面临着采用更高效系统的压力,该系统应纳入基本指标以评估其价值和对治疗结果的影响。当前大多数系统将放射科医生的激励措施和评估与基于相对价值单位(RVU)的生产率指标以及基于同行评审的质量指标挂钩。在一个新的潜在模式中,放射科医生的表现将越来越多地取决于一系列定义“价值”的参数,首先是同行评审指标,其中包括转诊医生的满意度以及放射科医生给转诊医生的反馈,该反馈用于评估针对特定检查所提供临床信息的有效性和正确性。这些价值衡量的新维度将直接影响后续医疗管理的一连串过程。我们分享我们在这个项目中的持续经验,该项目有两个组成部分:RESP(转诊医生评估系统试点)和FRACI(放射科医生解决混淆问题的反馈),它们被引入临床放射学工作流程,以便收集基于转诊医生和基于放射科医生的关于放射学报告的反馈。我们还分享我们对在其规划和执行中应用的设计思维原则的见解。