title: Understanding and Applying the Concept of Value Creation in Radiology.
abstract: The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer. We propose that the primary purpose of diagnostic radiology is to answer clinical questions using medical imaging to help guide management of patient care. Because they are the direct recipient of this service, we propose that referring clinicians are the direct customers of a radiology practice and patients are indirect customers. Radiology practices create value as they understand and fulfill their referring clinicians' needs. To narrow those needs to actionable categories, we propose a framework consisting of four major dimensions: (1) how quickly the clinical question needs to be answered, (2) the degree of specialization required to answer the question, (3) how often the referring clinician uses imaging, and (4) the breadth of imaging that the referring clinician uses. We further identify three major settings in which referring clinicians utilize radiological services: (1) emergent or urgent care, (2) primary care, and (3) specialty care. Practices best meet these needs as they engage with their referring clinicians, create a shared vision, work together as a cohesive team, structure the organization to meet referring clinicians' needs, build the tools, and continually improve in ways that help referring clinicians care for patients.
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California. Electronic address: david.larson@stanford.edu.
authors.forename: David B
authors.initials: DB
authors.lastname: Larson
authors.affiliation: LifeBridge Health, Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Durand
authors.affiliation: Henry Ford Health System, Detroit, Michigan.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Siegal
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D003952:Diagnostic Imaging / Q000191:economics*; D017598:Efficiency, Organizational / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D018803:Models, Economic; D017063:Outcome Assessment, Health Care / Q000191:economics*; D011871:Radiology / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics*; D014481:United States; D062505:Value-Based Purchasing
keywords: Value; customer; patients; referring clinicians