A New Level of Accountability
By Gordon Ah Tye, FAHRA
Our business used to be quite simple. There
were days when the highest ranking department head was called a chief tech and when
all of our equipment actually produced
x-rays. The high tech and digital world has
transformed us, as it has the world, into a
different, more sophisticated creature.
In the past, radiology was a mysterious
place. We were like an area of the hospital
that did lab experiments on people. We
made them drink chalky, horrible fluids;
pumped quarts of liquid into their rectums;
and injected them with clear fluids that
surely would make them feel hot all over,
nauseous, and sick. We used x-ray film by
the pallet, and waited anxiously while they
churned in vats of chemicals to see if our
images were acceptable. A common hospital
joke was that when someone couldn’t be
found, they were usually lost in x-ray.
The sophistication of what we do in our
departments and the accountability that
accompanies it has opened our eyes to more
regulatory and compliance requirements:
define exactly how we follow through on
critical findings in our results. It’s not
enough to just assume that the referring
physician would routinely receive a call
from the radiologists. There must be a
clearly defined process that the finding
was sent, received, and documented.
•;Oxygen;as;medication.;We;are;cur-rently addressing awareness that oxygen is a medication. For decades,
techs and aides have been connecting
and disconnecting oxygen from tank
to wall. It is no longer accepted that
techs and aides have the competency
to do so.
consistent with organizational nursing
standards. Radiology nurses had duties
and responsibilities that sometimes
were inconsistent with the rest of the
hospital. We have strengthened the
“dotted line” with our nurses in radiology to our hospital nursing and it has
been a valuable relationship to ensure
continuity of care.
imaging has redefined our contribution
as part of the electronic medical record.
Prior to PACS, we were simply the paper
report behind the x-ray tab in the chart.
Now all the images are a part of the
record. The complexity of who has
access, for what reasons, and how we
move them is a huge responsibility – no
different than any information that is
electronic and can be accessed.
incredibly complex and often leaves
me in a quandary. For larger or affili-
ated institutions, you may have the
resources to ensure you are coding
things correctly, and making changes
that ensure you are compliant. For
smaller, freestanding organizations,
you may not have the resources to
ensure you are coding correctly and
run the risk of coding incorrectly, over-
billing, or underbilling.
As our business of radiology has transformed into a broader spectrum of imaging services, it is changing the way we do
things. From medication administration
to radiation exposure, we have always
followed a more encapsulated approach
to what we do as related to the potential
effect on our patients’ health. Whether
you agree or not, imaging services is
already experiencing more required diligence and accountability for the services
we provide. Although it means more
complexity, and more work, in the longer
scheme of things, it will help to ensure we
are providing quality care to those we
serve. It’s a new day . . . and it requires a
new level of accountability.
Gordon Ah Tye is director of imaging and radiation
oncology services for Kaweah Delta Health Care
District in Visalia, CA. He holds a bachelor’s degree in
biological sciences from California State University in
Fresno. Gordon is a past president of AHRA, received
the AHRA Gold Award in 2001, and received the 2006
Minnie for Most Effective Radiology Administrator of
the year. He may be contacted at firstname.lastname@example.org.