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Strategy in Change

By Jef Williams

We are clearly entering a period of disruption that will reshape the way we provide care and conduct business. Whether it is federal policy, organizational restructuring (mergers and acquisitions) – or reimbursement changes – the next paradigm shift will bring radical changes to the way we deliver health care to patients.

One common thread that I’ve seen woven through the marketplace of ideas is that it is clearly not time for leaders to sit back and let the world go by. We have spent a number of years managing incremental change. With technology fully adopted we have managed to maintain growth and stability with minor adjustments. Most of us have spent the past several years managing departments and groups with small software, hardware and equipment procurements. Even with decreasing reimbursement, the landscape has not changed for most since the adoption and stabilization of digital imaging and information systems. The risk here is that we have been lulled into complacency as organizational leaders who have stopped diligently crafting strategy or contributing to the executive and administrative conversation that leads to the marginalization of your service line as well as your leadership.

What are we doing to prepare for a new paradigm that is coming – whether we are ready or not? We continue to store images in perpetuity at increasing costs and expansion of hardware – what are we doing to build logic into our archives? Redundant and ad hoc systems cannot be easily supported in an integrated environment – what are we doing to simplify and standardize? Images have to be shared both internally and externally – how are we positioned to share data simply, including patient access? Image management has expanded beyond radiology and cardiology into ophthalmology, visible light and other specialties – how are we prepared technically to manage all of that image data and give access to our radiologists as they deem appropriate? Fee-for-service is changing – how are we prepared for a shared savings reimbursement models? Outcomes and quality must be reported – how do we access the necessary data in ways that are intelligent, appropriate and efficient?

These are tough questions! They should make us uncomfortable. But addressing these issues is part of the leadership role we have chosen, and we owe it to our organizations to provide strategy and direction in meeting the growing challenges of imaging.

The answers to these questions should be part of an imaging strategy. This is where governance can play a critical role within your organization. We have worked in silos for years managing our service lines but there is an emerging trend of shared leadership. Much of what we learned from the implementation EHR governance within hospitals and outpatient centers can be applied to our imaging strategy. There is a growing trend toward collaborative governance in shaping organizational strategy.

To say that we are in times of uncertainty is an understatement. Our world is changing around us. The way we deliver health care is changing, and the requirements of our roles as leaders is changing. Often we can be distracted by the urgent and ignore the criticality of what is important. While we cannot predict the future, we can certainly design a roadmap for success.

Jef Williams, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners.



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