The answer is, without question, yes.
As a 24-hour, high-volume service with many different types of consumers — emergency physicians, surgeons, orthopedists, oncologists and family practitioners — radiology is under more complex demands than ever before. How can a hospital better serve its medical staff and keep quality high, while controlling costs? By developing a standards-based approach to radiology services. This approach has worked for many industries from manufacturing to high-technology.
Today, there is a lack of any best practices or standard criteria from clinical or medical associations to assist hospitals in assessing the caliber of radiology providers. Currently, radiology best practices focus on productivity, workflow and cost, because they are easily measured, but this is only a fraction of the total value radiology can bring to a hospital.
In the absence of any standards by which to judge the total value of radiologists, hospitals – and the entire payment system – only look at Relative Value Unit (RVU)-based productivity measures. But such a focus de-incentivizes valuable behavior in radiologists, such as clinician interaction in the form of consultations, calling in critical findings, and other help with case management.
So the question becomes, “How does radiology add value – improve quality and reduce costs at the hospital – and how do you measure it?”
Ultimately, the value of radiology increases as its contribution to improving patient care increases. For instance, if physicians can get reports that are of a higher quality and they can get them faster, they can make decisions about a patient sooner, and can do so based on better information. That’s value. A few ways to improve the quality of radiology reports are:
- Have subspecialists read studies that come from specialty physicians (which is increasingly the case). Typical coverage would include Body Imaging, Cardiovascular, Musculoskeletal, Neuroradiology, Nuclear Medicine, Pediatric and Women’s Imaging.
- Implement a rigorous Quality Assurance program, which includes peer review that is random, frequent and double-blind, to ensure that the highest level of clinical quality is maintained.
- Implement standard, check-list driven reporting tools to eliminate mistakes due to omissions and ensure complete and thorough reads and final reports.
These standards, combined with service level agreements related to final report delivery (turnaround time), will improve quality while reducing costs. And most importantly, it gives referring physicians what they need, when they need it.
Another way radiology can improve quality while reducing costs is through true partnership with referring physicians. Examples of such behavior include:
- Radiologists being available 24/7 for live consultations with physicians when questions arise or clarification is needed regarding a case.
- Radiologists not only documenting critical findings in the report, but also proactively calling the referring physician, at the time of diagnosis, to connect live when there is a critical finding.
- Radiologists actively participating in medical staff, MEC and tumor board meetings.
This type of behavior fosters trust, confidence and partnership between the referring physician and the radiologist to ensure patients are taken care of in an efficient, yet informed manner.
By establishing “best practices” criteria, and by setting standards by which to measure a radiologist’s performance to those best practices, the entire practice of radiology is elevated to a new level of value to referring physicians, and the hospital at large. Radiologists will better serve physicians, allowing physicians to better serve patients, which is the ultimate goal of everyone in healthcare.
The final word on standards-driven radiology is that it helps encourage transparency and accountability. In this manner, clinicians are better able, as noted by The Checklist Manifesto author Atul Gawande, M.D., to “master the extreme complexity that is the practice of Medicine.”
Alison Shurell is Chief Marketing Officer of Radisphere, a radiology services provider to rural and community hospitals. Prior to Radisphere, she worked for IntraLinks, Inc. (NYSE: IL), a global provider of B2B software-as-a-service solutions, where she led the launch of the company’s Life Sciences business. Contact her at firstname.lastname@example.org.