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Brady AP, Bello JA, Derchi LE, Fuchsjäger M, Goergen S, Krestin GP, Lee EJY, Levin DC, Pressacco J, Rao VM, Slavotinek J, Visser JJ, Walker REA, Brink JA. Radiology in the Era of Value-based Healthcare: A Multi-Society Expert Statement from the ACR, CAR, ESR, IS3R, RANZCR, and RSNA. Radiology 2020; 298:486-491. [PMID: 33346696 DOI: 10.1148/radiol.2020209027] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The Value-Based Healthcare (VBH) concept is designed to improve individual healthcare outcomes without increasing expenditure, and is increasingly being used to determine resourcing of and reimbursement for medical services. Radiology is a major contributor to patient and societal healthcare at many levels. Despite this, some VBH models do not acknowledge radiology's central role; this may have future negative consequences for resource allocation. Methods, findings and interpretation This multi-society paper, representing the views of Radiology Societies in Europe, the USA, Canada, Australia, and New Zealand, describes the place of radiology in VBH models and the health-care value contributions of radiology. Potential steps to objectify and quantify the value contributed by radiology to healthcare are outlined. Published under a CC BY 4.0 license.
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Affiliation(s)
- Adrian P Brady
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L.†, V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Jaqueline A Bello
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Lorenzo E Derchi
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Michael Fuchsjäger
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Stacy Goergen
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Gabriel P Krestin
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Emil J Y Lee
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - David C Levin
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Josephine Pressacco
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Vijay M Rao
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - John Slavotinek
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Jacob J Visser
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - Richard E A Walker
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
| | - James A Brink
- From Mercy University Hospital, Grenville Place, Centre, Cork, T12 WE28, Ireland (A.P.B.); European Society of Radiology (ESR), Vienna, Austria (A.P.B., L.E.D., M.F.); Montefiore Medical Center, New York, NY (J. Bello); American College of Radiology (ACR), Reston, Va (J. Bello, J. Brink); University of Genoa, Genoa Italy (L.E.D.); Medical University Graz, Graz, Austria (M.F.); Monash University, Melbourne, Australia (S.G.); Royal Australian and New Zealand College of Radiologists (RANZCR), Sydney, Australia (S.G., J.S.); Erasmus Medical Center, Rotterdam, the Netherlands (G.P.K., J.J.V., J. Brink); International Society for Strategic Studies in Radiology (IS3R), Vienna, Austria (G.P.K., J.J.V.); Langley Memorial Hospital, Langley, Canada (E.J.Y.L.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Thomas Jefferson University, Philadelphia, Pa (D.C.L., V.M.R.); Radiological Society of North America (RSNA), Oak Brook, Ill (D.C.L., V.M.R.); McGill University, Montreal, Canada (J.P.); Canadian Association of Radiologists (CAR), Ottawa, Canada (E.J.Y.L., J.P., R.E.A.W.); Flinders Medical Centre and Flinders University, Adelaide, Australia (J.S.); University of Calgary, Calgary, Canada (R.E.A.W.); Harvard Medical School, Boston, Mass (J. Brink)
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