PORTLAND, OR - As healthcare moves toward an emphasis on value over volume, it's time to rethink imaging and reinvent processes to facilitate patient-centric care, according to the opening general session at the Society for Imaging Informatics in Medicine (SIIM) annual meeting.
Quality of care is increasingly important in this new world, which necessitates a new focus for radiology, explained Dr. Rasu Shrestha, chief innovation officer at University of Pittsburgh Medical Center (UPMC).
"We can't just continue to treat a series of images at a time," he said. "We need to focus on the patient; what we really need is a patient-centric, collaborative, intelligent, value-based care platform."
For radiologists, that means changes such as transitioning from being report generators to becoming physician consultants, from being film-centric to becoming patient-centric, and from being interpretation-centric to being outcomes-centric, he said. In addition, software needs to be designed to provide empowerment for radiologists and clinicians, rather than to meet regulations.
How can this all be achieved? Shrestha shared his seven "secrets" for innovating to achieve patient-centered care.
1. Forget what you know
Challenge the status quo; it's really important to question the norm and what we've learned over the years, according to Shrestha. "This is how we've always done it isn't good enough," he said. "Innovation is anything but business as usual."
Healthcare shouldn't be just about preventing death. "In this new environment of value-based healthcare, it's really important to focus on living -- the quality of life and what's important to the [patient] on the other side of that screen," he said.
2. Humanize care
Understand that you are dealing with patients. The currency of trust that providers have with patients is critical. "Don't spend it in the wrong place," he said.
As a specialty, radiology needs to be involved in the care processes and what's important for patients. "Authenticity is really important," Shrestha added.
3. Embrace design thinking
Electronic medical record software has largely been designed to replace people-based work, and it has done that job well. However, "we've replicated the analog work to the point where the culture of analog holds us back from doing the things that we need to do," he said. "Ease of use may be invisible, but its absence sure isn't."
Design thinking is a process that's first and foremost about empathy, learning about the audience for whom the software is being designed and then defining what's important to the end users, Shrestha said. Next comes brainstorming and developing creative solutions, followed by prototyping and testing.
"It's a cycle of going through this process again and again to be able to get to what you actually need," he said.
4. Tame the data beast
There are a lot of data in healthcare today. "But it's not just about the data, it's about the smarts behind the data," he said. "It's about connecting the data and getting insights that are actionable and meaningful to the point of care for the end users of the data." That could include the patient.
5. Focus and simplicity
"It's really important for us to make sure that we're not just adding things, but that we're also taking things away and making them as simple as possible," Shrestha said. "We also shouldn't get distracted; focus is absolutely critical."
6. Be fearless
It's important to be fearless about the things you do and how you go about doing them, he said. UPMC has created a culture of embracing failure in designing solutions.
"We as radiologists and clinicians are really averse to failure," he said. "I think failure is a gift, and it's important to learn from your failures, because if you haven't learned from your failures, then in essence you have failed twice. And that's not good."
7. Aim for behavioral change
Innovation is ultimately about behavioral change, whether it's a patient who is exercising more, a physician who's ordering for the right reasons, or "a radiologist who's doing the right thing because that's what we know to do, but now we have the workflow to support it," he said.
Technology can't be in our face, however. "We have alert fatigue," he said. "Technology should be an enabler of the things that we need to do to push care forward."
A strategic imperative
UPMC is pursuing these strategies as a part of an innovation strategic imperative, Shrestha said. A few years ago, the institution launched UPMC Enterprises, an organization that aims to turn innovation ideas into businesses. Serving as a commercialization arm of UPMC, UPMC Enterprises invests in healthcare innovations that seek to solve problems facing the healthcare industry. It focuses on four areas:
- Clinical tools: Using data-driven and patient-centric clinical tools that reinvent care delivery
- Population health: Using data to manage risks and address new revenue models
- Business services and infrastructure: Developing ways to use technology to streamline business process delivery and improve operational efficiency
- Consumer: Reinventing how we engage with consumers to improve care and build relationships
UPMC also participates in the Pittsburgh Health Data Alliance, along with Carnegie Mellon University and the University of Pittsburgh.
This healthcare journey involves developing software that can build virtual bridges from patients to providers, as well as bridges to technologies that can be leveraged to facilitate the future of patient-centric care, according to Shrestha.
"Let's stop talking and start doing, because it's possible," he said. "We're starting to do it and would love to work with all of you to do it quicker. It's about fewer clicks and more moments."
