By Ted Smith, Senior VP of National Sales at Priority Care Solutions, a division of Genex Services
In workers’ compensation, diagnostic imaging – such as an MRI, CT, or PET scan – is often the first critical step to assess the severity of an injury and to develop a treatment plan for prompt recovery and return to work. It’s imperative that the use of a reliable facility that produces a quality image is utilized from the onset to ensure the best outcome for the injured worker.
However, obsolete imaging equipment has become a significant issue. Today, if injured workers require a scan, they could be sent to an imaging facility with old or outdated equipment, if that facility or equipment was not properly vetted in the first place.
According to a 2014 positon paper published by the European Society of Radiology, imaging equipment that is less than five years old is considered state-of-the-art technology. Properly maintained equipment that is between six and 10 years old is suitable for practice, but organizations should have a plan in place to upgrade these machines. And equipment that is over 10 years old is considered antiquated and should be switched out with newer models.
A recent report published by AXREM, an association representing suppliers of diagnostic imaging equipment, suggests that more than 50% of MRI and CT scanners in the UK are more than five years old, with more than 10% of CT scanners and more than 20% of MRI scanners, being over 10 years old. A similar study – with similar results – was performed in Canada.
Although a comparable study has not been performed in the United States, imaging equipment in our country is in a similar predicament. Regional newspapers across the U.S. have reported that local hospitals and facilities urgently need to replace aging scanners. However, these providers face critical challenges that triggered this trend in the first place. The primary one is cost. The financial outlay for newer machines is extremely high, creating a substantial barrier to ongoing equipment renewal in market. In addition, continued downward pressure on provider reimbursement has made it extremely difficult for imaging facilities to squirrel away the necessary funds for equipment upgrades.
The Benefits of Imaging Advancements
While investments in newer machines have been difficult to make, their advancements offer great promise. The latest equipment can enable health care providers to diagnose and treat patients with greater precision, giving them unprecedented visual and functional information on a patient’s condition. At the same time, newer equipment facilitates faster, more intelligent imaging services that supports medical decision-making, improves outcomes, and boosts the economics of imaging departments and facilities.
Since scans are faster, newer technology improves the patient experience. Twenty years ago, a CT might have taken half an hour. Today, newer technology can get the same information in less than two seconds. By that same token, an MRI might take up to 20 to 40 minutes, but the actual imaging itself only takes a few seconds or minutes of that time. Quicker scans enable facilities to see a greater number of patients in less time. Wait times are reduced.
Patient safety also improves. Manufacturers have worked to develop machines that use lower doses of radiation, while maintaining or enhancing the quality of images. However, with the number of aged equipment out there, injured workers may not experience the benefit of these advancements, including reduced exposure to radiation.
It’s important to note that for imaging equipment already on the market, their life and usefulness can be extended with system upgrades. However, these upgrades often only provide incremental improvements. And over time, older equipment will experience incompatibilities, which make updates impractical, if not impossible.
Results of Aging Equipment
Old equipment can lead to poor scans. Treating physicians may not have the information they need to diagnose and properly treat injured workers, or a bad scan could cause them to miss something in an injured worker’s condition.
A treating physician may have expected to receive the results within 24 to 48 hours of ordering the scan. When a poor image is returned, the injured worker must be contacted to schedule another appointment. While handling coordination, a week may go by, delaying treatment and return to work.
With older equipment, a lack of speed could also mean injured workers have to wait for tests. If they’re in the hospital, this could increase their stay. All of these factors contribute to increased medical and indemnity costs, not to mention disrupting the continuum of care, which could lead to less-than-optimal medical outcomes.
Addressing the Challenge
What’s needed is a thorough vetting process for diagnostic providers to ensure they have relatively new and up-to-date equipment that is capable of producing quality scans. Today, a sophisticated ancillary service provider will work with claims adjusters and payers to schedule imaging services only within a network of quality imaging facilities. These facilities have undergone a rigorous credentialing process to ensure the practice and staff have the proper licensure, certifications, and insurance.
An ancillary service provider also connects with other stakeholders. In this way, they can obtain feedback from adjusters, nurse case managers, and treating physicians about image quality. When a treating physician is unable to read a scan, they inform the ancillary service provider, so it can further investigate. If it’s an issue that could lead to ongoing quality concerns, the ancillary service provider will likely remove this facility from its network.
Leveraging Continued Innovation
There’s an urgent need for imaging facilities to replace outdated equipment to nurture a patient-centric approach to care. Aging technology – some of which dates back to the early ‘90s – is affecting the speed with which injured workers can be examined and diagnosed.
As we’ve discussed in this article, newer equipment can improve the quality of images, patient safety and the efficiency of imaging facilities. Updating equipment is needed both immediately and on an ongoing basis. New business models – such as managed equipment services, renting and leasing – have emerged, which may enable facilities to more economically renew their technology. Still, the industry will need to keep careful track of which facilities have new, updated or antiquated equipment. A quality ancillary service provider can be a strategic partner in this effort, helping to assess facilities and ensure injured workers benefit from quality scans.
About Ted Smith
Ted Smith is senior vice president of national sales at Priority Care Solutions, a division of Genex Services. With more than 10 years of experience in the workers’ compensation industry, Ted is an expert on managing ancillary services, including diagnostics, durable medical equipment (DME), and home health services. In his current role, Ted has worked to grow and expand the company’s offering. By nurturing key customer relationships, he has driven company revenue to meet and exceed financial objectives. He tracks industry trends, using these insights to lead a national team of regional sales directors.
About Priority Care Solutions
Priority Care Solutions (PCS), a division of Genex Services, is a leading specialty managed care services and network provider for the workers’ compensation industry. The company draws on the cumulative experience of its executive team with an average of 20 years in all areas of workers’ compensation. The company has used this experience to create unique, proactive solutions that mitigate risk, create operational efficiencies and reduce costs, while providing compassionate, exceptional, and timely care to injured workers.
Based in Tampa, Florida, PCS works to meet the ancillary service needs of carriers, third-party administrators, self-insured employers, government agencies and managed care organizations. Its comprehensive set of solutions has helped to tackle the industry’s most pressing challenges. The results are faster, more efficient and cost-effective claims resolution and injured workers who receive the care they need. For more information, visit www.prioritycaresolutions.com.