Valuing the Professional Work of Diagnostic Radiologic Services

Overview of Noninterpretive Artificial Intelligence Models for Safety, Quality, Workflow, and Education Applications in Radiology Practice

Artificial intelligence has become a ubiquitous term in radiology over the past several years, and much attention has been given to applications that aid radiologists in the detection of abnormalities and diagnosis of diseases. However, there are many potential applications related to radiologic image quality, safety, and workflow improvements that present equal, if not greater, value propositions to radiology practices, insurance companies, and hospital systems. This review focuses on six major categories for artificial intelligence applications: study selection and protocoling, image acquisition, worklist prioritization, study reporting, business applications, and resident education. All of these categories can substantially affect different aspects of radiology practices and workflows. Each of these categories has different value propositions in terms of whether they could be used to increase efficiency, improve patient safety, increase revenue, or save costs. Each application is covered in depth in the context of both current and future areas of work. Keywords: Use of AI in Education, Application Domain, Supervised Learning, Safety © RSNA, 2022.

Comprehensive review of the limitations of relative value unit measurements of productivity in academic departments

Measuring radiologist, especially sonologist, productivity has never been of greater interest than now, as radiology has moved from its historical status as a cost center to the largest revenue generator in most institutions. With more local institutional and federal oversight and regulation into the reimbursement and valuation of imaging procedures, including emphasis on outsourcing, overvalued procedures, and bundling, the ability to measure productivity and to draw meaningful conclusions from the data becomes increasingly imperative if we as radiologists and sonologists expect to contribute meaningfully to the process. This article presents a history of the "relative value unit" and discusses the valuation of radiologist/sonologist productivity in this era of ubiquitous high-technology implementation.

Workload of consultant radiologists in a large DGH and how it compares to international benchmarks

AIM

To measure radiologist workloads in a UK radiology department using relative value units (RVUs), and compared these data to current international standards from Australia and Ireland.

MATERIALS AND METHODS

Data on reporting throughput was gathered for 13.5 whole-time equivalent (WTE) consultants at the DGHs of East Lancashire Hospitals Trust (ELHT) between April 2010 to March 2011. RVUs were assigned to the reported imaging studies to create a crude RVU/WTE score. This was compared to benchmarks from Australia and results from a similar study in Ireland. Time spent on teaching, multidisciplinary teams, and administration was factored in to create a net RVU/WTE score, more accurately assessing workload.

RESULTS

Radiologists in ELHT reported 110,315 imaging studies, producing a total of 649,617 RVUs. Crude reporting workloads were 48,119.78 RVUs/WTE, and net workloads were 83,674.00 RVUs/WTE (with consultants spending 42.49% of their time on non-reporting commitments). These crude and net workloads are far above the Australian maximum reporting benchmark of 45,000 RVUs.

CONCLUSION

The workload is much higher than international benchmarks, indicating high-quality service and excellent value for money, but also highlights understaffing. Foreign RVU systems do not accurately reflect current UK practices and a UK-specific RVU system should be developed to assess staffing and analyse performance.

Measuring Consultant Radiologist workload: method and results from a national survey

Objectives

The role of the Consultant Radiologist has changed substantially in recent decades, yet manpower planning is often based on older inappropriate methods of measuring Radiologist workload. We report a nationwide survey of Consultant Radiologist workload in Ireland in 2009.

Methods

Relative value units (RVUs) were assigned to easily countable studies. Hospitals’ activity was collated for the full calendar year of 2009. Radiologist time engaged in activities not easily counted (interventional and procedural work, multi-disciplinary meetings, teaching, administration, etc.) was separately measured.

Results

Data were obtained from 28 of 38 public hospital radiology departments. Mean Consultant Radiologist workload across all hospitals was 57,659.1 crude RVUs/WTE and 103,987 net RVUs/WTE. A mean of 32.47% of WTEs are engaged in non-countable activity. Means of 85.35% and 65.73% of the required numbers of WTEs were available in 2009 to achieve respectively annual crude and net RVU/WTE figures of 45,000. Excluding Specialist Centres, plain films accounted for 28–41% of recorded activity, mammography for 0.8–5.8%, US for 16–20%, CT for 27–32% and MR for 5.9–15.8%.

Conclusions

Irish Consultant Radiologist staffing levels are well below appropriate international benchmarks for the current workload. Approximately one-third of radiologist time is engaged in activity not easily counted in study numbers.

The Economic Environment of 2006: How Safe Is Your Practice and What You Can Do to Protect It

In 2006, there was no doubt that imaging was in the crosshairs of just about everyone who had a role in legislation, regulation, and payment involving these medical services. The information in this article was presented at the ACR's Annual Meeting and Chapter Leadership Conference in Washington, DC, on May 25, 2006. It describes the factors contributing to the current economic environment for medical imaging, the external responses to those factors, the dangers to practicing radiologists, and potential strategies to mitigate the damage.