Theres a scene in the 2002 science fiction movie Minority Report in which Tom Cruise stands in front of a Romper Room-sized computer screen and speeds through a multitude of photo and text files by merely moving his hands across the screen. That futuristic vision could become the de rigueur work environment of radiologiststhat is, if vendors at this years Radiological Society of North America conference (which took place Nov. 25-30 at McCormick Place in Chicago) are successful in hawking their new wares.
However, other news from the event indicates that these new toys may not find enough buyers with the needed deep pockets to make the dream a reality.
The technical exhibits at this years event included at least two vendors who featured interactive reading-room and remote-consultation technology reminiscent of room-sized iPhones.
Over at the Philips Medical Systems booth, for example, convention models showed off a concept radiology reading room where the view screen and controls of a desktop computer were in the surface of the desktop. Instead of a mouse and keyboard, radiologists used tactile commands like sweeping hand gesture and circles, boxes or letters drawn by their fingers on top of a large tabletop to view and move around radiology images, physician reports and other medical information. Instead of passwords, the system used facial and voice recognition software, and during a simulated teleconference the consulting doctors used virtual notepads that automatically took notes of their conversation.
McKesson Corp., a healthcare information technology company, was promoting a similar touch-screen technology that allowed physicians to quickly access, highlight and enhance images for viewing. Then, with a sweep of the hand, they could e-mail an image and report to a consulting colleagues iPhone. On the same screen, the physician was able to quickly produce and file a bill for services rendered.
Such leapfrog technology was among the RSNA conferences most popular drawseven if hospitals and radiology-center owners werent in the buying mood this year. Make no mistake, despite buzz over such techno-gadgets, the main topic of conversation among medical professionals and vendors alike was the cloud of uncertainty hanging over the radiology industry.
Whether they were there to pitch products, teach continuing education courses, present research or learn about the newest techniques and developments in radiology nearly everyone at RSNA lamented the striking effects of the Deficit Reduction Act of 2005. The budget law, which went into effect in February, aims to save Medicare roughly $2.8 billion over five years by reducing reimbursement for outpatient imaging services. Conference participants, however, were often heard quoting a much higher figure when referencing the financial effect of the law on the radiology industry. According to many, the reimbursement cuts will most likely trim $1.2 billion annually over the next five years.
Representatives from the healthcare law firm McDermott Will & Emery were among the imaging-industry pundits bandying about the larger-loss figure during a separate medical imaging symposium in Chicago. Presenters there focused on how forthcoming expansion of the Stark II lawthe set of federal rules banning physician self-referralalong with additional proposed cuts to imaging reimbursements will likely have further effects on everything from partnership arrangements of physician-owned imaging centers to doctors and imaging centers reimbursement rates.
Whats more, according to insurer UnitedHealthcare, which participated in the off-site seminar, a growing number of private payers are giving greater scrutiny and are increasing the hurdles that both hospital-owned and freestanding imaging centers and their providers will have to jump in order to qualify for reimbursement. Laurie Paidosh, director of radiology programs for UnitedHealthcare, told a roomful of providers and radiology center owners that her company will soon begin requiring radiology professionals and facilities approved for reimbursement to pursue a higher standard of credentialing and accreditation. They will also look for greater application of evidence-based guidelines by physicians referring patients for imaging procedures.
I think what we might be seeing is a perfect storm coming together, said Eric Zimmerman, a partner in McDermott Will & Emery of the current environment. There is a lot of pressure on Congress to find savings in the healthcare budget. At the same time, theres a very consistent progression in the volume of imaging services and some statistics suggesting that (imaging referrals) are growing at twice the rate of other services.
Its all starting to have a very big impact on Medicare spending. Nearly one-fourth of all spending on hospital services go to imaging.
So it really looks like all those interactive toys on display at RSNA may have to wait for a Christmas in the distant future.