Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery RSS feed: Current Issue. http://www.seminarsinbreastdisease.com/?rss=yesElsevier Inc.en © 2008 Published by Elsevier Inc. All rights reserved. Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery1092-4450114December 2008 © 2008 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.seminarsinbreastdisease.com/article/PIIS1092445009000313/abstract?rss=yesEditorial Board10.1053/S1092-4450(09)00031-3Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0iihttp://www.seminarsinbreastdisease.com/article/PIIS1092445009000325/abstract?rss=yesContents10.1053/S1092-4450(09)00032-5Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0iiiihttp://www.seminarsinbreastdisease.com/article/PIIS1092445009000131/abstract?rss=yesRadiologists who specialize in breast cancer diagnosis are a dying breed due to the many changes occurring in the breast imaging field. Today, clinical evaluation of patients with breast problems is critical for an accurate diagnosis. This evaluation may include clinical breast examination, additional mammographic views, ultrasonography, ductography, fine needle aspiration cytology (FNAC), core needle biopsy, and breast magnetic resonance imaging (MRI). These allows the mammographer to be highly accurate at diagnosing breast cancer and determining extent of the disease process.IntroductionStamatia Destounis10.1053/j.sembd.2009.05.001Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0167168http://www.seminarsinbreastdisease.com/article/PIIS1092445009000192/abstract?rss=yesIn our outpatient Breast Center, we have spent years establishing a workflow pattern that is efficient for our facility. In the following pages, we will describe the unique and effective workflow designed to meet our patients' needs. We have developed a Radiology Information System (RIS), which includes patient scheduling, film requests, patient tracking, pathology results, and patient health history. We average 250 screening patients a day, with an additional 50-100 diagnostic patients. We are now 100% digital, using a picture archiving and communication system (PACS) and a homegrown RIS. Daily we strive to maintain the highest professional standards while providing the patient with excellent service. With an efficient behind-the-scenes workflow, the patient experiences seamless professional interaction in an environment that serves her needs and addresses her concerns.A Day at Elizabeth Wende Breast Care, LLC: Work and Patient FlowPatricia Somerville10.1053/j.sembd.2009.05.006Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0169179http://www.seminarsinbreastdisease.com/article/PIIS1092445009000167/abstract?rss=yesThe integration of picture archiving and communications systems (PACS) into our private practice in order to create a more efficient workflow and office environment has been a challenging and time-consuming work-in-progress affair. While transitioning to a digital environment, we began to incorporate PACS into our daily practice. Since 2005, we have been working with our PACS vendor to continue to change our PACS to suit our needs. We worked through initial connectivity and technical issues, and these problems were resolved through the combined efforts of our PACS vendor, the imaging vendors, and our dedicated homegrown IT and PACS departments. As time has progressed, over the last 4 years so has the role PACS has played in our office. We continually make innovations within our facility to create more efficient workflow and office environment, but also continue to provide excellent patient care, and our PACS continue to play a major role.Cutting Edge Technology in Breast Imaging: PACSDiana Kissel, Shannon DeMay, Philip F. Murphy10.1053/j.sembd.2009.05.007Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0180183http://www.seminarsinbreastdisease.com/article/PIIS1092445009000155/abstract?rss=yesAs clinical research in the last several years has continued to reveal the importance of magnetic resonance imaging (MRI) use in breast imaging, we forged ahead to implement breast MRI in our private practice workflow. The initial start-up costs were prohibitive, so our facility decided to start our MRI experience with a mobile unit. This enhanced our experience and comfort level and initiated our ongoing negotiations for MRI growth with our referring doctors, our patients, and our local insurers. It has been a learning curve for everyone involved with the implementation process. In the end, we established an outpatient MRI practice and built a stationary MRI suite that has suited our work environment. This happened slowly, always with serious consideration to finances, local environment, and workflow issues.Implementation of Breast MRI into a Private PracticeStamatia Destounis, Andrea Arieno10.1053/j.sembd.2009.05.003Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0184186http://www.seminarsinbreastdisease.com/article/PIIS1092445009000180/abstract?rss=yesTo maintain our portion of the market share and to recruit new patients, our practice has used different marketing methods and tactics to promote our practice and advertise our standard of care. We have spent time and energy investigating the types of customers practices are competing for, including patients, referring physicians, employees, and payers. You cannot know enough about your business or competition. We use many different methods when designing our marketing plan, including tactics to develop physician referrals, tactics to develop new patients and maintain current patient volume, and education of the patients, public, and physicians. We will go into more detail in the following pages. We believe that marketing is not doing any one thing well; it is doing many things well all at once. We continually solicit feedback through surveys and going out into the community, from our patients and referring physicians.Marketing the PracticeTheresa Wade, Posy Seifert10.1053/j.sembd.2009.05.005Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0187194http://www.seminarsinbreastdisease.com/article/PIIS1092445009000179/abstract?rss=yesPeriodically, a practice needs to evaluate contracts with payers and renegotiate the contracts that are performing poorly. Using a relative value unit (RVU) cost analysis, one can determine what the costs are per unit of service. Before you can attempt to negotiate, you must know your practice expenses, demographics, and clinical outcomes. It is important to consider the following about your practice: specialty services or procedures, location of the practice, accessibility, convenience of parking, and patient satisfaction data. Will the loss of your group's participation create a marketing problem for the plan or payer? What percent of your income is from this payer? Can you walk away from this contract? Using RVU cost analysis, you are able to review procedure expenses and profitability, internal and external fee schedules based on practice expenses, and a contract negotiation starting point based on RVU cost and use.Preparing To Negotiate With PayersTheresa Wade, Posy Seifert10.1053/j.sembd.2009.05.004Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0195197http://www.seminarsinbreastdisease.com/article/PIIS1092445009000143/abstract?rss=yesThis article aims to describe how ethically and efficiently research has been conducted in our practice. What started out as a very informal set of internal checks and balances at our practice has evolved into a very busy research department. We now have numerous internal and external studies. Research opportunities include computer-aided detection, full field breast ultrasound, elasticity imaging, cone beam computed tomography of the breast, and breast tomosynthesis. There are many ways a mammography center can conduct research; we have found that commitment is a major factor. Each project needs adequate time and supervision. The dedication must be there to see the projects through to completion.How Research Is Conducted in a Private PracticeStamatia Destounis, Renee Morgan, Valerie Andolina10.1053/j.sembd.2009.05.002Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery 11, 4 (2008)2008-12-01Seminars in Breast Disease: Diagnostic Imaging, Medical Oncology, Pathology, Radiation Oncology, Surgery2008-12-01114S1092-4450(09)X0005-0198201