Lately I have noticed another misalignment in several stakeholders specific to imaging, or Radiology.
At the system level there has been a focus and trend to take costs out of the supply chain. One of the focuses has been on contrast media. How much to buy, when to buy it, how is it used, who to purchase it from, efficacy difference, and how cheap can we obtain it.
From a safety perspective there has been an initiative to document the use of contrast media for each patient. The amount of contrast being administered, the type of contrast administered, the site of administration, any side effects or reactions, who and when it is administered, and the patient education being delivered in the medical management system. A process typically managed by pharmacy.
Historically the Radiology department has controlled the ordering, the expense, the type, the amount, the management, the documentation, and the education of contrast media with patients.
With a shift of contrast media to the pharmacy, pharmacists are now trying to understand what has been done historically, and how to quickly meet their own standards of medication reconciliation and documentation. The pharmacy department now has to ensure that the radiology department is trained and that the documentation on the type/amount/date of contrast administered is done and that the patient education is performed. Plus, it is an added “cost” to the bottom line of pharmacy.
Recently I conducted a survey both on Twitter as well as on my blog (Take the survey here) asking patients when they would prefer to be educated about the use and risks of contrast media related to their imaging exam. Almost 80% of respondents (60 total) have said they prefer to be educated about contrast media at the time that the exam is ordered.
Which leads me to sharing this insight:
Several countries in Europe, patients are given a written prescription for contrast media. (oral and IV contrast) The patients are then responsible for going to the pharmacy to obtain the contrast media from the pharmacist at which time the patient is initially educated on the use of contrast, as well as informed on the risks and benefits of its use specific to the imaging exam. The patient is then given instructions to take the contrast with them to their imaging exam.
Maybe the United States Healthcare System could pull a page out of the playbook of a European country as mentioned above.
Listening to the patient and meeting their needs allows us to shift the right work to their right people at the right time.
When we align around the right work for the patient, it somehow always meets the needs of the stakeholders.
Remember, we scale one patient at a time.
As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek