By Tim Kearns

PACS/RIS have streamlined image management in radiology departments, imaging centers and radiology group practices, leading to greater efficiency and productivity. Given the prevalent staffing shortages in healthcare, especially among radiologists and technologists, automating administrative workflow in radiology departments and practices can free up staff for other important patient-related tasks, such as prepping patients for imaging exams or reviewing safety requirements (e.g., MRI safety checks).

However, some aspects of the patient care pathway remain manual, particularly patient management tasks such as checking eligibility and pre-authorization for billing, scheduling recommended follow-up exams including incidental findings, and more. Automating these administrative tasks with tools that utilize workflow-based AI provides many other financial, clinical and patient benefits to radiology practices.

Studies have shown that approximately 50% of recommended patient next steps contained in radiology reports, including incidental findings, are not acted upon and often result in missed or delayed diagnoses. Automating this process has been shown to increase patient follow-up rates, which can improve patient outcomes and increase adherence to additional aftercare recommendations by 60% or more.

Ensuring patients receive recommended care is a challenge in practices today. Missed follow-up appointments represent a significant gap in healthcare that can potentially impact a patient’s overall quality of health. Early diagnosis of a disease improves outcomes and reduces the financial burden to patients with less invasive or less intensive treatment regimens. Automating proper patient follow-up by extracting data directly from the radiology report and creating an action – a text to the patient or an electronic fax to the referring physician – improves the quality and timeliness of patient care.

Additionally, in an era of declining reimbursements, automating each step of the scheduling process – authorization, estimation and eligibility – can reduce administrative staff tasks to help reduce staff burnout. Capturing insurance eligibility, billing and co-pays during the patient scheduling process can help ensure income/fees are not missed and are received in a timely manner. For example, different states and payers have different authorization requirements. Automating this process not only makes the workflow simpler for both staff and patients, it also helps the practice collect the required information needed to submit to insurance and avoid incomplete or rejected claims.

Providing patients with accurate upfront estimates for out-of-pocket costs ensures price transparency and compliance with the 2022 No Surprise Act (NSA), with the opportunity to collect payments right away or create a payment plan. And by ensuring eligibility and pre-authorization when required, radiology departments and practices can avoid late cancellations and gaps in the schedule where imaging equipment may be idle and not fully utilized. This is particularly relevant for exams that require certain conditions be met, such as having a radiologist on site during contrast administration.

Solutions to streamline these common daily tasks with workflow AI are becoming available and may be offered by PACS/RIS manufacturers. These solutions should be integrated into the existing administrative workflow and not as a standalone system. Implementing these solutions in a radiology practice does more than increase administrative productivity: it can also improve the quality and timeliness of patient care, enhance the patient and staff experience, assist the staff in helping guide the patient through their clinical pathway, and provide financial benefits for practices by capturing the appropriate fees from insurance and patients.

About the author: Tim Kearns is the director of marketing, HCIT, at Konica Minolta Healthcare Americas, Inc.