por Sean Ruck
, Contributing Editor | February 26, 2019
From the January/February issue of HealthCare Business News magazine
HCB News: Are there dramatic differences in the technology being used and the training in different member countries?
The training curricula prepared by the ESR have been endorsed by our National Societies members. This endorsement has been put into action, since most of the national training programs in Europe have been developed following the contents proposed in the ESR curricula, thereby demonstrating that our harmonising effort is working. Regarding the technologies being used, there are relatively wide differences in terms of numbers of high-end machines within the different nations. However, as far as I know, the variations are not dramatic. At a European level, patient organisations are working to decrease differences in terms of availability and ease of access, but the quality of services offered by radiologists is quite high in all European nations.
HCB News: In last year’s ESR interview, a key challenge for members was the cost reduction drivers in healthcare and austerity measures being pushed. Has the problem increased, decreased or remained steady in the last 12 months?
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There are still problems in the healthcare systems in Europe, although these differ from nation to nation. The main way of measuring the services provided by radiology is based on the volume of examinations performed, meaning “productivity” is what most administrators want from us. The last time I met one of our regional health administrators, here in Genoa, he told me that he expected from us radiologists more examinations with less expenses. He stated this without mentioning any quality criteria about our work, just as if radiological departments were “examination factories” and the approach to each patient could be standardised with a correct and timely diagnosis granted in each instance.
We, however, have to recognize that, following the debate on value-based healthcare started in the USA a few years ago, discussions about a new way of providing reimbursements to caregivers according to the outcomes of the care provided have also started in Europe. The ESR has recently published a white paper about value-based radiology, discussing the “value” of radiological examinations in patient care and suggesting metrics to measure it. Furthermore, the society is currently working on a paper addressing this topic, together with some of the most important radiological societies worldwide, to be published in a major general medicine journal. Additionally, it must be underlined that in many European healthcare systems, and even at EU level, a lot of attention is paid to the appropriateness of radiological requests. Through a collaboration with the ACR (American College of Radiology), the ESR has developed a Clinical Decision Support system that integrates imaging guidelines into the ordering system of hospitals, guiding referring physicians to request the most appropriate study for each clinical indication. The “ESR iGuide” system is already used and fully integrated in a number of institutions throughout Europe, and the results obtained by its use will be discussed at ECR 2019.