Integrating the Healthcare Enterprise (IHE) has recently published a new integration profile aimed at addressing IMR (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9485305/).

Yet, even with new technical method and integration guidance, challenges to adoption remain. Results generated using IMR generate no additional reimbursement, but many Radiologists have the perception that IMR reports take longer to create (more work for less money). Not all clinicians, and certainly not patients, fully understand the benefits, and are not generating strong demand. Not all procedures, like simple ankle X-rays, benefit from the effort put into IMR, so only a subset of procedures (like complex CT exams) will likely see significant benefits. Many EMR integration teams are more comfortable with the exchange of traditional HL7 ORU results, which provide none of the benefits of IMR, but are well-understood and have proven interoperable between systems. Finally, the display of IMR reports is more complex than traditional unformatted results, limiting the systems that can present the data consistently, safely, and effectively.

RIS
In early 2020 and again in 2022, I wrote articles for HealthCare Business News on the two prevailing types of RIS: stand-alone and as part of the EMR. Not much has changed in 2023. Large enterprises are commonly adopting the RIS module provided by their EMR vendor, which provides some system efficiencies and reduced interfacing. Reading groups, imaging centers, and smaller health systems adopt stand-alone RIS, or ones available from their PACS vendor, and establish interfaces with one or more HIS/EMR systems.

The number of mature, stand-alone RIS is limited in many markets, especially the U.S. Many of the innovations coming from this class of RIS are focused on functions for improving the patient experience, including through the use of text-messaging notifications and self-serve patient portals.

Healthcare provider operations
Over the past several years, diagnostic imaging departments have changed how they operate. Many changes are driven by policies or simply habits established as part of a consolidation of departmental IT staff to a central enterprise team and the implementation of an enterprisewide EMR system, which leads to a focus on performance measures, analytics, and adoption of workflow best practices that cross departmental lines.

One practice observed among imaging IT professionals in recent years is the need to estimate costs and expected savings for individual projects prior to approval and initiation. Likely driven by practices established by EMR teams and vendors, many imaging IT staff either lack the internal labor costing data or (sometimes) the financial analysis skills to prepare these projections, leading to too many assumptions.

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