For years, within the X-ray community, the rate of technological innovation has outpaced the actual adoption rate for that new technology. While many healthcare providers have purchased new X-ray systems in recent years, a surprising number retain legacy systems that are 10, or even 15, years old.
Why has X-ray’s rate of technological adoption not kept pace with, for example, computed tomography (CT) and magnetic resonance imaging (MRI)? Largely because many providers have regarded it as a “necessary evil” — as little more than a commodity. But that outdated notion is giving way to a new realization.
Healthcare professionals perform upward of 70 percent of all imaging using some form of X-ray technology. That figure suggests a high number of touch-points between patient and system during the continuum of care. And since patient satisfaction is now a major factor in determining a provider’s total reimbursement, this stalwart technology can substantially impact a facility’s bottom line, as healthcare and the reimbursement environment evolve.
Similar to the way in which the 2014 passage of the XR-29 dose optimization legislation has reduced reimbursement for facilities using older CT systems, X-ray reimbursement is now — thanks to the Consolidated Appropriations Act of 2016 — tied to clinical standards. Those standards take the form of Medicare payment incentives for transitioning from traditional film and cassette-based computed radiography (CR) to digital radiography (DR).
The financial impact of these changes, coupled with the clinical and operational benefits of today’s X-ray technology over the equipment’s useful life, highlight the need for dramatic change in the X-ray community’s rate of technological adoption. Rather than “buy on the cheap” as they may have done when they viewed X-ray as a commodity, providers will need to “purchase smarter” when considering new X-ray systems. Only then will they ensure greater investment protection in an ever-changing healthcare environment.
We’ve already seen ways in which technological innovation has revolutionized X-ray. For example, where CR once held sway, DR is now ascendant — for both fixed rooms and mobile radiography systems. The reasons are clear: DR offers superior image impression compared to film and up to 50 percent in patient dose reduction compared to CR. Consider also how dynamic flat panel (or digital) detectors have replaced image intensifiers in fluoroscopy systems. A similar transition is underway within the mobile C-arm segment, bringing the promise of improved image resolution and up to four times less dose. This technological shift represents a coming of age within X-ray.
And as we saw when dedicated fluoroscopy systems were supplanted by a new breed of units that combined fluoro with X-ray capabilities, providers are eager to increase system utility. They want multi-clinical technology to maximize existing facility space and equipment utilization. Meeting that demand, an emerging class of multi-clinical systems will marry radiography, fluoroscopy, basic angiography and 3-D imaging in one room.
The boundaries of X-ray adoption will expand still further. Already, automation for equipment setup has helped providers ensure greater consistency of outcomes in addition to aiding technologists. Soon, we will see widespread adoption of robotic X-ray equipment that not only aids patient setup and exam consistency, but also allows the X-ray tube and detector to automatically move around the patient, and not the other way around. These robotic systems will provide the vital ingredient of standardized, replicable and more efficient care. As hospitals and providers continue to form large healthcare systems and integrated delivery networks (IDNs), the need for system-wide standardization of X-ray creates an opportunity to rethink yesterday’s purchasing behavior and usher in smarter investment strategies.
Clearly, a confluence of factors — led by the rapid advance of imaging technology and the changing reimbursement structure — underscore a fundamental shift in how X-ray is regarded within the healthcare community. Now is the right time to invest in X-ray.
The Consolidated Appropriations Act of 2016 includes new Medicare and Medicaid provisions affecting the use of film screen and computed radiography (CR) imaging. Download Cassling's trend report to learn how this impacts you.
Originally published in DOTmed HealthCare Business News Magazine.