Top trends in diagnostic imaging

Systemness

Radiology departments, across provider networks, are realizing that by working together they can help overcome staffing challenges, complicated payment processes and adapt to changes in how care is provided. This type of collaboration allows for joint resources, expertise and technology to better overcome these challenges. Acting as a system places a governance structure in place to optimize resources across sites of care and enables procedures to be available in more locations. A good example of how imaging providers are achieving systemness is using remote scanning platforms. These platforms allow expert clinicians to operate imaging equipment from a different location.

Diagnostic imaging companies are responding to the trend of working together systematically, by helping providers expand collaboration across the care continuum. For example, some dual-source CT systems offer the capabilities for more complex cardiac exams with guidance for less experienced technologists — but at a more cost-effective installation compared to other dual-source CT systems. Imaging suppliers are also enhancing digital product portfolios. These portfolios allow for more synchronous and standardized processes for image reconstruction, archiving and sharing between clinician care teams.

Workforce challenges

Radiology staffing challenges hinder diagnostic services. Factors contributing to these challenges include an aging radiology workforce, a limited pipeline of residency and technologist program graduates and the growing complexity of imaging studies. Additionally, the geographic distribution of radiologists can be uneven, with rural areas often experiencing more severe shortages.

To address these challenges, healthcare organizations are exploring various strategies. These strategies include implementing remote diagnostic reading programs, applying advanced technologies like artificial intelligence to assist with image interpretation and offering competitive compensation packages to attract and retain radiologists. Investing in AI-guided technology, remote working options and other recruitment efforts can all help with the shortage. A resurgence of accredited radiology technologist programs along with investing in recruitment of high school and college students may help bolster a pipeline of technologists.¹ With diagnostic imaging volumes expected to grow, securing a sufficient workforce and adoption of workforce enhancing technology is imperative.

Capital asset management

The Vizient Capital Asset Management solution has helped organizations achieve market-leading financial value in the past fiscal year. By Leveraging data-driven insights and best practices, Vizient provider customers are achieving efficiency gains and potential savings of up to 15% across their capital equipment programs.

Provider capital equipment committees require clear insights to achieve their strategic objectives across their organization, as they navigate the balance between replacing aging equipment fleets and meeting requests for modern technology. Larger provider networks are aligning capital equipment strategies across care sites to capitalize on standardization, increase spending power and optimize financing options. When considering the latter, providers must consider factors like capital commitment amount, lifespan, technology changes, terms and conditions, liquidity and use, cost of capital and credit impact to determine financing options.

Smart providers are including capital equipment plans in their long-term clinical strategies to ensure they have the right technology for the future. Harnessing these insights to plan objectively enhances the organization’s ability to plan funding options that best suit the financial performance of the organization.

Sustainable imaging: pioneering environmental responsibility in radiology

Sustainable radiology (or green radiology) has been identified as an area of opportunity for collective action to impact environmental sustainability. As the healthcare sector works toward reducing its carbon footprint, radiology departments are being urged to invest in sustainable practices. These practices aim to decrease energy consumption, minimize waste and promote the use of renewable energy. Imaging suppliers are also investing in programs to reduce carbon emissions and waste. Providers are leveraging federal programs and industry support from manufacturers to aid their efforts toward a greener and more sustainable practice in radiology.

Technology user-ability

Diagnostic Imaging technology has experienced a great deal of innovation over the last decade that's expanded capabilities to a wide range of complex exams. Shifting sites of care, workforce challenges and increased patient volumes have resulted in more users, with varying level of expertise, who need training to maximize technology capabilities across the continuum of care. Diagnostic imaging equipment manufacturers have created equipment that helps healthcare professionals provide high-quality patient care, regardless of their workload or experience level. Features like embedded AI programs, automatic patient positioning, portable and remote scanning and workflow guidance applications help clinicians improve efficiency, quality of care and satisfaction for both providers and patients.

Rise of remote imaging and expert technologists

Remote scanning is a technology for operating diagnostic imaging equipment through a network connection. In the U.S., its adoption has been limited due to regulations and policies. However, providers are now using remote scanning to address staffing challenges by pooling resources and implementing it as a solution.

The demand for imaging procedures is growing throughout organizations, and providers are recognizing the need to efficiently share the expertise of highly trained, expert technologists. Experienced technologists (also known as scan managers) can oversee and help in complex imaging procedures via remote scanning.² These individuals guide less trained individuals, who are present on-site, in positioning and preparing the patient. Not only does this enhance quality and access for patient care, but it multiplies the training opportunities for less experienced technologists.

Remote scanning can retain experienced technologists by offering remote work options. Providers should consider compliance risks, but many still turn to remote scanning out of necessity.

Artificial intelligence

The Food and Drug Administration (FDA) has established criteria for evaluating and approving artificial intelligence (AI) applications. However, there is currently no standard method in the industry for evaluating the impact of these applications on quality patient care, which is needed to advance reimbursement. Even so, providers are steadily adopting radiology AI, even though widespread reimbursement is limited.

Providers evaluate their return on investment (ROI) based on their organization’s clinical goals. For AI applications that don't receive reimbursement, the ROI is typically measured in terms of efficiency and quality improvements rather than direct cost savings. AI vendors are working to make it easier for their offerings to be implemented, which can positively impact ROI. For example, AI vendors are partnering with platforms that vet AI applications, deploy them safely within a provider's network and track usage and ROI metrics. Reimbursement could be on the horizon for radiology AI applications, but for now, transformative gains in efficiency, accuracy and provider satisfaction can still be measured.

Reimbursement pressure

Despite an increasing demand for diagnostic imaging services, a downward pressure on reimbursement for most areas of radiology continues to be the standard. Radiology was set to receive a 4.5% payment cut from the Centers for Medicare and Medicaid Services (CMS) in 2023 that was reduced to about 2% following an intervention from U.S. Congress.³ For 2024, CMS finalized a 3.4% cut to the physician fee schedule, with interventional radiology facing a 4% cut in the total. ^4,5

Several professional societies, such as the American College of Radiology (ACR), are urging lawmakers to address the ongoing and unsustainable cuts to reimbursement. There's growing concern that if these reductions continue, patient access to radiology services will suffer, especially in rural areas that are already underserved.

Value-based procurement

In the past, radiology suppliers have sold their products to providers without being held accountable for the impact on care quality and operational metrics. Providers want suppliers to demonstrate how their products can help achieve clinical and operational goals. They also want suppliers to share in the risk if these goals aren't met.

Providers are changing how they evaluate equipment purchases and collaborate with suppliers post-purchase. Suppliers need innovative solutions to adapt. Providers need a network of resources to fully use and measure the value of these solutions over time.

Mergers and acquisitions

The imaging market is highly competitive and fragmented, with the top 100 practices representing less than 20% of the total market.⁶ The industry is experiencing a broad shift in volumes from hospital settings to OP centers, with OP imaging growth outpacing the overall radiology market. Forty percent of radiology volume is now performed at OP imaging centers and clinics.⁷

Mergers and acquisitions (M&A) in the radiology market have been gaining momentum over the past decade, and the COVID-19 pandemic has accelerated M&A activity, especially among smaller imaging centers.

“Coming out of the pandemic, smaller imaging centers find themselves in a vulnerable financial position,” said Kris Blohm, a managing director in Kaufman Hall’s Mergers & Acquisitions practice. “Private equity, hospitals and larger imaging center networks all continue to invest and acquire across the U.S., with many of the larger imaging chains demonstrating aggressive acquisition strategies. Not-for profit health systems are also partnering in joint ventures with some of the larger imaging and radiology players, many of which have private equity backing.”