1
|
Rawson JV, Rubin E, Smetherman D. Short-Term Strategies for Augmenting the National Radiologist Workforce. AJR Am J Roentgenol 2024. [PMID: 38568035 DOI: 10.2214/ajr.24.30920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
The current radiology landscape has an imbalance between the rising demand for radiology services and the national radiologist workforce available. More vacant radiology positions exist than graduating radiology trainees. The origins of this problem are complex and require long-term solutions. Rather than working longer and/or faster, there are ways for radiologist to work smarter. In this article, we present multiple short-term strategies to increase the effective radiologist workforce and/or increase workforce efficiency, in order to alleviate the current workload challenges. These strategies are derived based on an analysis of possible practice-level changes in personnel, process, and physical plant. The impacts of the potential changes are estimated. No single change addresses the mismatch between supply and demand for radiology services. By creating an inventory of potential solutions, practices can choose the potential mechanism(s) to address the workforce shortage that best fit their needs and local environment.
Collapse
Affiliation(s)
- James V Rawson
- Vice Chair of Operations & Special Projects, Department of Radiology, Beth Israel Medical Center, Harvard Medical School, One Deconess Road, Boston, MA 02215
| | - Eric Rubin
- Medical Director, CT Division, Crozer Health, 1 Medical Center Blvd, Upland, PA 19013
| | - Dana Smetherman
- Chair, Department of Radiology, Ochsner Medical Center - New Orleans, 1516 Jefferson Hwy., New Orleans, LA 70121
| |
Collapse
|
2
|
Zafar HM, Rawson JV. Liberating Structures in Strategic Planning: Methods to Foster Engagement. Acad Radiol 2024; 31:438-445. [PMID: 38401990 DOI: 10.1016/j.acra.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 02/26/2024]
Abstract
This paper describes the innovative approach of using liberating structures to the development of the AUR 2023 strategic plan, and lessons learned in their application. The 2023 strategic plan built on the results and approach of the prior 2015 plan. Similar to the 2015 strategic plan, traditional tools such as a SWOT analysis and strategic retreat were used. In addition, the 2023 process included tools called liberating structures and was iteratively co-produced through a series of virtual meetings over 18 months. Advantages of liberating structures included increased creativity and speed in moving through meeting tasks, increased number of meaningful contributions from AUR members and increased engagement from participants during discussions and meetings. The 2023 AUR strategic plan is provided along with examples of completed goals and those under early implementation. Lessons learned from using these tools for strategic planning can be applied to other society and group meetings. Moving forward, the 2023 strategic plan will be a living document, which will be reviewed at each Board of Directors meeting and periodically adapted.
Collapse
Affiliation(s)
- Hanna M Zafar
- Vice Chair Quality, Department of Radiology, Hospital of the University of Pennsylvania, Founders 1, 3400 Spruce Street, Philadelphia, Pennsylvania, 19146, USA (H.M.Z.).
| | - James V Rawson
- Vice Chair Operations & Special Projects, Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, Massachusetts, 02215, USA (J.V.R.).
| |
Collapse
|
3
|
Larocque N, Brook OR, Kavandi H, Brook A, Rawson JV. Quality Improvement Report: Adherence to Follow-up Recommendations for Incidental Abdominal Aneurysms. Radiographics 2023; 43:e220121. [PMID: 36995945 DOI: 10.1148/rg.220121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
The use of national guidelines for the management of incidental radiologic findings remains low. Therefore, improving adherence to and consistency with follow-up recommendations for incidental findings was undertaken in a large academic practice. A gap analysis was performed, and incidental findings of abdominal aneurysms for which reporting management recommendations could be improved were identified. The Kotter change management framework was used, and institution-specific dictation macros were developed and implemented in February 2021 for the management of abdominal aortic aneurysms (AAAs), renal artery aneurysms (RAAs), and splenic artery aneurysms (SAAs). A retrospective medical record review was conducted for February through April in 2019, 2020, and 2021 to assess reporting adherence and imaging and clinical follow-up. Personal feedback was provided to radiologists in July 2021 with repeat data collection in September 2021. A significant increase in the number of correct follow-up recommendations was reported for incidental AAAs and SAAs after implementation of the macro (P < .001). However, there was no significant change for RAAs. Providing personal feedback to radiologists further improved adherence with standard recommendation macros for common findings and dramatically increased adherence for rare findings such as RAAs. New macros resulted in an increase in AAA and SAA imaging follow-up (P < .001). Institution-specific dictation macros were found to improve adherence to reporting recommendations for incidental abdominal aneurysms, with further improvement seen after feedback, which can have a significant effect on clinical follow-up. © RSNA, 2023.
Collapse
Affiliation(s)
- Natasha Larocque
- From the Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton Street E, Hamilton, ON, Canada L8L 2X2 (N.L.); and Department of Radiology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (N.L., O.R.B., H.K., A.B., J.V.R.)
| | - Olga R Brook
- From the Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton Street E, Hamilton, ON, Canada L8L 2X2 (N.L.); and Department of Radiology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (N.L., O.R.B., H.K., A.B., J.V.R.)
| | - Hadiseh Kavandi
- From the Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton Street E, Hamilton, ON, Canada L8L 2X2 (N.L.); and Department of Radiology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (N.L., O.R.B., H.K., A.B., J.V.R.)
| | - Alexander Brook
- From the Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton Street E, Hamilton, ON, Canada L8L 2X2 (N.L.); and Department of Radiology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (N.L., O.R.B., H.K., A.B., J.V.R.)
| | - James V Rawson
- From the Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton Street E, Hamilton, ON, Canada L8L 2X2 (N.L.); and Department of Radiology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (N.L., O.R.B., H.K., A.B., J.V.R.)
| |
Collapse
|
4
|
Rawson JV. Operationalizing Collaboration in the COVID Era. Acad Radiol 2023; 30:569-571. [PMID: 36858878 DOI: 10.1016/j.acra.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 03/02/2023]
Affiliation(s)
- James V Rawson
- Harvard Medical School, Boston Massachusetts (J.V.R); Department of Radiology, Beth Israel Medical Center, Boston, MA (J.V.R) 02215.
| |
Collapse
|
5
|
Bulman JC, McQuiston SA, Bedi HS, Rawson JV. "Coopetition" in Practice: Regional Collaborations in Radiology Resident Education. Acad Radiol 2023; 30:621-624. [PMID: 36849335 DOI: 10.1016/j.acra.2023.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/29/2023] [Accepted: 01/29/2023] [Indexed: 02/27/2023]
Affiliation(s)
- J C Bulman
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215 (B.J.C., R.J.V.); University of South Alabama Health System, Mastin Building, Mobile, Alabama (M.S.); Department of Radiology, Boston University School of Medicine, Boston, Massachusetts (B.H.S.).
| | - S A McQuiston
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215 (B.J.C., R.J.V.); University of South Alabama Health System, Mastin Building, Mobile, Alabama (M.S.); Department of Radiology, Boston University School of Medicine, Boston, Massachusetts (B.H.S.)
| | - H S Bedi
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215 (B.J.C., R.J.V.); University of South Alabama Health System, Mastin Building, Mobile, Alabama (M.S.); Department of Radiology, Boston University School of Medicine, Boston, Massachusetts (B.H.S.)
| | - J V Rawson
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215 (B.J.C., R.J.V.); University of South Alabama Health System, Mastin Building, Mobile, Alabama (M.S.); Department of Radiology, Boston University School of Medicine, Boston, Massachusetts (B.H.S.)
| |
Collapse
|
6
|
Rawson JV, Stevens JP. Scenario Planning Approach to Adapting in the COVID Era. Acad Radiol 2022; 30:572-578. [PMID: 36528426 PMCID: PMC9751975 DOI: 10.1016/j.acra.2022.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
RATIONALE AND OBJECTIVES The COVID-19 pandemic has caused much uncertainty and disruption in healthcare resulting in many challenges for strategic planning. Scenario planning is a tool that allows healthcare leaders to plan healthcare delivery strategies by incorporating the uncertainties into the analysis and planning process. MATERIALS AND METHODS Variables were identified which will have major impact on the future, but whose future direction is uncertain. The extremes of these drivers were used to generate multiple scenarios. A subset of scenarios was used to evaluate potential tactics to determine which may be high yield in the face of uncertainty. RESULTS Unlike traditional strategic planning, scenario planning does not develop a single future with a path to that future. Scenario planning evaluates tactics to determine which would be helpful in specific scenarios, multiple different futures or under specific conditions. CONCLUSION We present a scenario planning model which can be used to determine specific tactics to accommodate the uncertainty due to variable healthcare delivery needs in the COVID-19 era.
Collapse
Affiliation(s)
- James V. Rawson
- Harvard Medical School, Boston Massachusetts,Department of Radiology, Beth Israel Medical Center, One Deaconess Rd, Boston, MA 02215,Address correspondence to: J.V.R
| | - Jennifer P. Stevens
- Center for Healthcare Delivery Design, Beth Israel Deaconess Medical Center, Massachusetts,Division of pulmonary, critical care, and sleep medicine, Beth Israel Deaconess Medical Center, Massachusetts
| |
Collapse
|
7
|
Siegal DS, Wessman B, Zadorozny J, Palazzolo J, Montana A, Rawson JV, Norbash A, Brown ML. Operational Radiology Recovery in Academic Radiology Departments After the COVID-19 Pandemic: Moving Toward Normalcy. J Am Coll Radiol 2020; 17:1101-1107. [PMID: 32682744 PMCID: PMC7833200 DOI: 10.1016/j.jacr.2020.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
This article presents a current snapshot in time, describing how radiology departments around the country are planning recovery from the baseline of the coronavirus disease 2019 pandemic, with a focus on different domains of recovery such as managing appointment availability, patient safety and workflow changes, and operational data and analytics. An e-mail survey was sent through the Society of Chairs of Academic Radiology Departments list server to 114 academic radiology departments. On the basis of data reported by the 38 survey respondents, best practices and shared experience are described for three key areas: (1) planning for recovery, (2) creating a new normal, and (3) measuring and forecasting. Radiology practices should be aware of the common approaches and preparations academic radiology departments have taken to reopening imaging in the post-coronavirus disease 2019 world. This should all be done when maintaining a safe and patient-centric environment and preparing to minimize the impact of future outbreaks or pandemics.
Collapse
Affiliation(s)
- Daniel S Siegal
- Vice Chair of Radiology, Henry Ford Hospital, Department of Radiology, Henry Ford Health System, Detroit, Michigan.
| | - Brooke Wessman
- Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - Jessica Zadorozny
- Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - Josie Palazzolo
- Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - Alysia Montana
- Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - James V Rawson
- Vice Chair, Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alexander Norbash
- Chairman of Radiology, Department of Radiology, University of California San Diego, San Diego, California
| | - Manuel L Brown
- Department of Radiology, Henry Ford Health System, Detroit, Michigan
| |
Collapse
|
8
|
Canon CL, Enzmann DR, Grist TM, Meltzer CC, Norbash A, Omary RA, Rawson JV, Recht MP. Society of Chairs of Academic Radiology Departments Statement of Support for Paid Parental Leave. J Am Coll Radiol 2019; 16:271-272. [PMID: 30832826 DOI: 10.1016/j.jacr.2018.12.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Cheri L Canon
- Professor and Chair Department of Radiology University of Alabama at Birmingham 619 South 19th Street Birmingham, AL 35249-6830.
| | - Dieter R Enzmann
- Chair and Distinguished Professor, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles
| | - Thomas M Grist
- Professor and Chair, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Carolyn C Meltzer
- Professor and Chair, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Alexander Norbash
- Professor and Chair, Department of Radiology, University of California, San Diego School of Medicine, La Jolla, California
| | - Reed A Omary
- Professor and Chair, Department of Radiology and Radiological Sciences, Professor of Biomedical Engineering, Vanderbilt University Medical Center & School of Medicine, Nashville, Tennessee
| | - James V Rawson
- Vice Chair of Operations & Special Projects, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michael P Recht
- The Louis Marx Professor and Chair, Department of Radiology, NYU Langone Health, New York, New York
| |
Collapse
|
9
|
Rawson JV, Cronin P. What Is Health Services Research? Acad Radiol 2018; 25:545-546. [PMID: 29631926 DOI: 10.1016/j.acra.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 11/16/2022]
Affiliation(s)
- James V Rawson
- Radiology and Imaging, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912.
| | - Paul Cronin
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109
| |
Collapse
|
10
|
Kang SK, Rawson JV, Recht MP. Supporting Imagers' VOICE: A National Training Program in Comparative Effectiveness Research and Big Data Analytics. J Am Coll Radiol 2017; 15:1451-1454. [PMID: 29221999 DOI: 10.1016/j.jacr.2017.09.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 12/26/2022]
Abstract
Provided methodologic training, more imagers can contribute to the evidence basis on improved health outcomes and value in diagnostic imaging. The Value of Imaging Through Comparative Effectiveness Research Program was developed to provide hands-on, practical training in five core areas for comparative effectiveness and big biomedical data research: decision analysis, cost-effectiveness analysis, evidence synthesis, big data principles, and applications of big data analytics. The program's mixed format consists of web-based modules for asynchronous learning as well as in-person sessions for practical skills and group discussion. Seven diagnostic radiology subspecialties and cardiology are represented in the first group of program participants, showing the collective potential for greater depth of comparative effectiveness research in the imaging community.
Collapse
Affiliation(s)
- Stella K Kang
- Department of Radiology, NYU School of Medicine, New York, New York; Department of Population Health, NYU School of Medicine, New York, New York.
| | - James V Rawson
- Radiology and Imaging, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Michael P Recht
- Department of Radiology, NYU School of Medicine, New York, New York
| |
Collapse
|
11
|
Rosenkrantz AB, Rawson JV. Trends in Publications in Radiology Journals Designated as Relating to Patient-Centered Care. J Am Coll Radiol 2017; 14:703-709. [DOI: 10.1016/j.jacr.2016.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 09/14/2016] [Accepted: 09/17/2016] [Indexed: 10/20/2022]
|
12
|
Patel SS, Hawkins CM, Rawson JV, Hoang JK. Professional Social Networking in Radiology: Who Is There and What Are They Doing? Acad Radiol 2017; 24:574-579. [PMID: 28153576 DOI: 10.1016/j.acra.2016.09.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 03/30/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
Abstract
RATIONALE AND OBJECTIVES Although it is perceived that the use of social media professionally is increasing among radiologists, little is known about the habits and demographics of this subspecialty. This study aims to compare radiologists who use social networking for professional purposes to those who do not with regard to their characteristics, habits, and attitudes. MATERIALS AND METHODS Radiologists were invited by e-mail and through posts on social networks to participate in a survey on the use of social media platforms. Questions included type of user, pattern of use, and benefits and barriers. Professional users and professional nonusers were compared. RESULTS One hundred eighty-six radiologists responded. One hundred ten (59.1%) used social networking for professional purposes, 34 (18.2%) for personal-use only, and 42 (22.6%) denied using social media. LinkedIn was the most common platform among all professional users, and Twitter was the most commonly used platform among highly active professional users. Trainees comprised 52 out of 110 (47.3%) professional social networking users compared to 18 out of 76 (23.7%) nonusers (P < 0.01). A subgroup analysis on Twitter use for professional purposes revealed a significant gender difference: 15 out of 66 (22.7%) professional Twitter users were female compared to 48 out of 120 (40.0%) non-Twitter users (P < 0.05). The greatest barrier to professional social media use for nonusers was confidentiality. CONCLUSION Nearly 60% of radiologist respondents use social networking for professional purposes. Radiology is likely to see growth in the role of social networking in the coming years as nearly half of professional users are radiology trainees. Twitter use for professional purposes among radiologists was disproportionately male. It is important to be cognizant of gender imbalance and to improve visibility of female leaders on social networking.
Collapse
|
13
|
Cook TS, Willis MH, Abbott C, Rawson JV, Krishnaraj A. Out of the Darkness and Into the Light: Patients, Referring Physicians, and Radiologists Working Toward Patient- and Family-Centered Care in Radiology. J Am Coll Radiol 2017; 14:569-572. [DOI: 10.1016/j.jacr.2016.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 08/05/2016] [Accepted: 08/15/2016] [Indexed: 10/20/2022]
|
14
|
Rawson JV, Kitts AB, Carlos RC. Patient- and Family-Centered Care: Why Radiology? J Am Coll Radiol 2016; 13:1541-1542. [DOI: 10.1016/j.jacr.2016.09.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 10/20/2022]
|
15
|
Rawson JV, Mitchell L, Golden L, Murdock A, Haines GR. Lessons Learned From Two Decades of Patient- and Family-Centered Care in Radiology, Part 1: Getting Started. J Am Coll Radiol 2016; 13:1555-1559. [DOI: 10.1016/j.jacr.2016.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 10/20/2022]
|
16
|
Grayson J, Basciano P, Rawson JV, Klein K. Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination. J Am Coll Radiol 2016; 12:1413-8. [PMID: 26614887 DOI: 10.1016/j.jacr.2015.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/05/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. METHODS Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. RESULTS In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. CONCLUSIONS A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships.
Collapse
Affiliation(s)
- James Grayson
- Hull College of Business Administration, Georgia Regents University, Augusta, Georgia
| | - Peter Basciano
- Hull College of Business Administration, Georgia Regents University, Augusta, Georgia
| | - James V Rawson
- Department of Radiology and Imaging, Medical College of Georgia, Georgia Regents University, Augusta, Georgia.
| | - Kandace Klein
- Department of Radiology and Imaging, Medical College of Georgia, Georgia Regents University, Augusta, Georgia
| |
Collapse
|
17
|
Rawson JV, Cronin P. Health Services Research Tools for the Next Generation of Radiologists. Acad Radiol 2016; 23:527-8. [PMID: 27017134 DOI: 10.1016/j.acra.2016.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 02/25/2016] [Indexed: 11/15/2022]
Affiliation(s)
- James V Rawson
- Department of Radiology and Imaging, Medical College of Georgia, Augusta University, 1120 15th St., Augusta, GA 30912.
| | - Paul Cronin
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, Ann Arbor, Michigan
| |
Collapse
|
18
|
Rawson JV, Kannan A, Furman M. Use of Process Improvement Tools in Radiology. Curr Probl Diagn Radiol 2016; 45:94-100. [DOI: 10.1067/j.cpradiol.2015.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/20/2015] [Accepted: 09/22/2015] [Indexed: 11/22/2022]
|
19
|
Rawson JV. Recruitment: A Critical Leadership Task. Acad Radiol 2015; 22:1469-70. [PMID: 26592693 DOI: 10.1016/j.acra.2015.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 09/29/2015] [Accepted: 09/29/2015] [Indexed: 10/22/2022]
|
20
|
Janiak BD, Rawson JV, Clayton SK. Unnecessary Repeat Radiologic Examinations in the Emergency Department After Interfacility Transfer. J Am Coll Radiol 2015; 12:1079-81. [DOI: 10.1016/j.jacr.2015.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 05/08/2015] [Indexed: 10/23/2022]
|
21
|
Rawson JV. CBCT: Wide Range of Clinical Applications and Wide Range of Doses. Ann ICRP 2015; 44:7-8. [PMID: 26320277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
22
|
Rawson JV. Radiology Testing in Population Health. Acad Radiol 2015; 22:805-6. [PMID: 25979590 DOI: 10.1016/j.acra.2015.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- James V Rawson
- Department of Radiology and Imaging, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912.
| |
Collapse
|
23
|
Affiliation(s)
- James V Rawson
- Department of Radiology and Imaging, Medical College of Georgia, Georgia Regents University Augusta, Georgia
| |
Collapse
|
24
|
Hawkins CM, Hillman BJ, Carlos RC, Rawson JV, Haines R, Duszak R. The Impact of Social Media on Readership of a Peer-Reviewed Medical Journal. J Am Coll Radiol 2014; 11:1038-43. [DOI: 10.1016/j.jacr.2014.07.029] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/20/2014] [Indexed: 11/30/2022]
|
25
|
Cronin P, Rawson JV, Heilbrun ME, Lee JM, Kelly AM, Sanelli PC, Bresnahan BW, Paladin AM. How to critically appraise the clinical literature. Acad Radiol 2014; 21:1117-28. [PMID: 25107864 DOI: 10.1016/j.acra.2014.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 04/30/2014] [Accepted: 05/03/2014] [Indexed: 12/24/2022]
Abstract
Recent efforts have been made to standardize the critical appraisal of clinical health care research. In this article, critical appraisal of diagnostic test accuracy studies, screening studies, therapeutic studies, systematic reviews and meta-analyses, cost-effectiveness studies, recommendations and/or guidelines, and medical education studies is discussed as are the available instruments to appraise the literature. By having standard appraisal instruments, these studies can be appraised more easily for completeness, bias, and applicability for implementation. Appraisal requires a different set of instruments, each designed for the individual type of research. We also hope that this article can be used in academic programs to educate the faculty and trainees of the available resources to improve critical appraisal of health research.
Collapse
|
26
|
Cronin P, Rawson JV, Heilbrun ME, Lee JM, Kelly AM, Sanelli PC, Bresnahan BW, Paladin AM. How to report a research study. Acad Radiol 2014; 21:1088-116. [PMID: 25107863 DOI: 10.1016/j.acra.2014.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 04/30/2014] [Accepted: 04/30/2014] [Indexed: 01/21/2023]
Abstract
Incomplete reporting hampers the evaluation of results and bias in clinical research studies. Guidelines for reporting study design and methods have been developed to encourage authors and journals to include the required elements. Recent efforts have been made to standardize the reporting of clinical health research including clinical guidelines. In this article, the reporting of diagnostic test accuracy studies, screening studies, therapeutic studies, systematic reviews and meta-analyses, cost-effectiveness assessments (CEA), recommendations and/or guidelines, and medical education studies is discussed. The available guidelines, many of which can be found at the Enhancing the QUAlity and Transparency Of health Research network, on how to report these different types of health research are also discussed. We also hope that this article can be used in academic programs to educate the faculty and trainees of the available resources to improve our health research.
Collapse
|
27
|
Rawson JV, Cronin P. Decision support: the super highway between health services research and change in clinical practice. Acad Radiol 2014; 21:1081-2. [PMID: 25107861 DOI: 10.1016/j.acra.2014.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 05/22/2014] [Accepted: 05/26/2014] [Indexed: 01/05/2023]
Affiliation(s)
- James V Rawson
- Department of Diagnostic, Therapeutic and Interventional Radiology, Medical College of Georgia, Georgia Regents University, 1120 15th St, Augusta, GA 30912.
| | - Paul Cronin
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, Ann Arbor, MI
| |
Collapse
|
28
|
Hawkins CM, Duszak R, Rawson JV. Social Media in Radiology: Early Trends in Twitter Microblogging at Radiology's Largest International Meeting. J Am Coll Radiol 2014; 11:387-90. [DOI: 10.1016/j.jacr.2013.07.015] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 07/15/2013] [Indexed: 11/28/2022]
|
29
|
Rawson JV, Ros PR. Academic Radiology in 2020: articles based on the 2012 AUR Carestream Innovations in Academic Radiology Course. Acad Radiol 2013; 20:1189. [PMID: 24029049 DOI: 10.1016/j.acra.2013.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 08/04/2013] [Accepted: 08/08/2013] [Indexed: 10/26/2022]
Affiliation(s)
- James V Rawson
- Department of Diagnostic, Therapeutic and Interventional Radiology, Medical College of Georgia at Georgia Regents University, GA
| | | |
Collapse
|
30
|
Rawson JV, Pelletier AL. When to Order a Contrast-Enhanced CT. Am Fam Physician 2013; 88:312-316. [PMID: 24010394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Family physicians often must determine the most appropriate diagnostic tests to order for their patients. It is essential to know the types of contrast agents, their risks, contraindications, and common clinical scenarios in which contrast-enhanced computed tomography is appropriate. Many types of contrast agents can be used in computed tomography: oral, intravenous, rectal, and intrathecal. The choice of contrast agent depends on route of administration, desired tissue differentiation, and suspected diagnosis. Possible contraindications for using intravenous contrast agents during computed tomography include a history of reactions to contrast agents, pregnancy, radioactive iodine treatment for thyroid disease, metformin use, and chronic or acutely worsening renal disease. The American College of Radiology Appropriateness Criteria is a useful online resource. Clear communication between the physician and radiologist is essential for obtaining the most appropriate study at the lowest cost and risk to the patient.
Collapse
Affiliation(s)
- James V Rawson
- Medical College of Georgia at Georgia Health Sciences University, Augusta, GA, USA
| | | |
Collapse
|
31
|
Cronin P, Rawson JV. Health services research in radiology: meeting the needs of the professions and the patients. Acad Radiol 2013; 20:1061-2. [PMID: 23931416 DOI: 10.1016/j.acra.2013.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/03/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
|
32
|
Heilbrun ME, Rawson JV, Shah M. Using health services research to meet ACGME resident research requirements. Acad Radiol 2013; 20:1077-82. [PMID: 23931420 DOI: 10.1016/j.acra.2013.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 05/10/2013] [Accepted: 05/15/2013] [Indexed: 11/18/2022]
Abstract
Health services research is a field of research that crosses many disciplines. It represents a novel way to address the Accreditation Council for Graduate Medical Education requirements for scholarly activity of residents and faculty in academic radiology departments. In addition to meeting training requirements, it offers future radiologists the opportunity to develop skills that will be essential as we transition from a volume based health care delivery system to an outcome based delivery system. This report introduces examples of health services research projects and the types of data resources that are available to facilitate such projects.
Collapse
Affiliation(s)
- Marta E Heilbrun
- Department of Radiology, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84231-2140, USA.
| | | | | |
Collapse
|
33
|
Carlos RC, Rawson JV. Introduction to the special issue-Health Care Reform: darkness before dawn? J Am Coll Radiol 2013; 9:682-3. [PMID: 23025859 DOI: 10.1016/j.jacr.2012.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 06/08/2012] [Indexed: 11/28/2022]
|
34
|
|
35
|
Cronin P, Rawson JV. Making use of the evidence to guide coverage decisions. Acad Radiol 2012; 19:1047-8. [PMID: 22877984 DOI: 10.1016/j.acra.2012.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 05/29/2012] [Accepted: 06/07/2012] [Indexed: 11/17/2022]
|
36
|
Rawson JV. Comparative effectiveness research in radiology: patients, physicians and policy makers. Acad Radiol 2011; 18:1067-71. [PMID: 21420332 DOI: 10.1016/j.acra.2011.01.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 11/15/2010] [Accepted: 01/14/2011] [Indexed: 10/18/2022]
Abstract
Health care costs continue to rise, with significant geographic differences in spending on health care and outcomes within the United States. The goal of comparative effectiveness research is to reduce health care spending without adversely effecting overall health according to the Congressional Budget Office. There are unique challenges and barriers to applying comparative effectiveness research to radiology, including rapidly changing technology, complex multistep care processes, and the burden of proving the impact of a diagnostic exam on patient outcome. Radiology shares other challenges of acceptance of comparative effectiveness research results (diffusion of new knowledge and successful implementation of changes in clinical practice) with all of health care, but with the added complication that radiologists do not order radiology exams.
Collapse
|
37
|
Lee DW, Rawson JV, Wade SW. Radiology Benefit Managers: Cost Saving or Cost Shifting? J Am Coll Radiol 2011; 8:393-401. [DOI: 10.1016/j.jacr.2010.11.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 11/23/2010] [Indexed: 11/28/2022]
|
38
|
Bernardy M, Ullrich CG, Rawson JV, Allen B, Thrall JH, Keysor KJ, James C, Boyes JA, Saunders WM, Lomers W, Mollura DJ, Pyatt RS, Taxin RN, Mabry MR. Strategies for managing imaging utilization. J Am Coll Radiol 2010; 6:844-50. [PMID: 19945039 DOI: 10.1016/j.jacr.2009.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 08/02/2009] [Indexed: 12/28/2022]
Abstract
Imaging represents a substantial and growing portion of the costs of American health care. When performed correctly and for the right reasons, medical imaging facilitates quality medical care that brings value to both patients and payers. When used incorrectly because of inappropriate economic incentives, unnecessary patient demands, or provider concerns for medical-legal risk, imaging costs can increase without increasing diagnostic yields. A number of methods have been tried to manage imaging utilization and achieve the best medical outcomes for patients without incurring unnecessary costs. The best method should combine a prospective approach; be transparent, evidence based, and unobtrusive to the doctor-patient relationship and provide for education and continuous quality improvement. Combining the proper utilization of imaging and its inherent cost reduction, with improved quality through credentialing and accreditation, achieves the highest value and simultaneous best outcomes for patients.
Collapse
Affiliation(s)
- Mark Bernardy
- Charlotte Radiology PA, Charlotte, North Carolina, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
Medicare's hospital outpatient prospective payment system (HOPPS) was initially developed in response to the rapid rise in Medicare's outpatient expenses between 1980 and 1991. The Balanced Budget Act of 1997 mandated HOPPS, with an implementation date of August 1, 2000. Unlike the Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services (CMS) used hospital charge data to develop the ambulatory patient classification (APC) payment weights. During its evolution as a payment system, Congress mandated the creation of an advisory panel as well as the removal of diagnostic mammography from the APCs. The Deficit Reduction Act proposes applying HOPPS for paying technical fees in nonhospital settings.
Collapse
Affiliation(s)
- James V Rawson
- Department of Diagnostic, Therapeutic and Interventional Radiology, Medical College of Georgia, Augusta, GA 30912-0006, USA.
| | | |
Collapse
|
40
|
|
41
|
Rawson JV, Siegel MJ. Techniques and strategies in pediatric body MR imaging. Magn Reson Imaging Clin N Am 1996; 4:589-98. [PMID: 8832846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The tools available from MR imaging provide the pediatric radiologist great versatility in detecting and characterizing disease in children. An understanding of the strengths and limitations is essential for selecting the best technique to answer the clinical question in the shortest amount of time.
Collapse
Affiliation(s)
- J V Rawson
- Department of Radiology, Medical College of Georgia, Augusta, Georgia 30912, USA
| | | |
Collapse
|
42
|
|
43
|
Rawson JV. A Non-Mathematical Approach to Basic MRI. Radiology 1990. [DOI: 10.1148/radiology.177.3.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|