How to Build the Radiology Department of the Future

In a presentation titled “The Radiology Department of the Future — Maintaining Profits From Imaging as the World Evolves,” Phillip Heckendorn, CEO, and David Walker, COO of RadCare, discussed ideas on how the radiology department could be most efficient and profitable over the next few years. “We’ve got a large scale divestiture by the radiology practices,” said Mr. Heckendorn. “CMS continues to scrutinize expenditures and imaging bundling. I think we are going to continue to see this going forward. We’ve also seen a decrease in compensation for radiology over the past 12 to 24 months and a consolidation across practices.”

Mr. Heckerdon sees several trends continuing in the future, including:
·    Employment of radiologists
·    Importance placed on quality
·    Return of the hospital imaging department as the epicenter of the radiology department
·    Hospital partnerships with local radiology practices
·    Falling reimbursement and multiple procedure payment reduction
·    Requests for hospital subsidies for the radiology department

“Moving to an outcomes-based reimbursement model is an important shift, and it goes a step beyond implementation of EMR,” said Mr. Heckendorn. “Radiology becomes a leader in promoting clinical outcomes or pathways. What I would strongly suggest is outcomes-based reimbursement, meaningful use and appropriate utilization will be cornerstones to radiology’s place in the ACO model.”

Many radiology departments are currently inefficient because radiologists might begin work at 7am and leave at 4pm, right before the emergency room business begins to pick up. When radiologists arrive in the morning, they must catch up on the reads from the previous night before beginning reads from that day, making the turnover time several hours longer than it would be if the reports were being read as they were taken. Teleradiology is one way to mitigate this time lapse because teleradiologists can read the reports as they come in, even if they are on the evenings or weekends.

“There are two barriers to teleradiology; the first is the perception of less quality,” says Mr. Heckendorn. “Establish the same quality peer review standards for offsite practices as onsite practices. There should be a primary standardization of quality across the board. The second barrier is really the loss of control. Your typical radiology practice sees final results without the preliminary read as a threat to the practice themselves. Under healthcare reform there is cost associated with preliminary exams and these barriers need to be overcome.”

The minimum requirements suggested to engage radiology provides includes:
·    Appropriate staffing plan
·    Define hours of coverage onsite and offsite
·    Adherence to quality standards across the board
·    Define metrics and infrastructure to monitor quality and report on metrics
·    Infrastructure support customer service initiatives
·    Full disclosure on potential competitive conflicts

“You have radiologists who ran to build their own centers and now they are running back to the hospitals, putting hospitals back into the driver’s seat in radiology and the future of imaging,” says Mr. Walker. “There is going to be give and take to relook at how we design radiology.”


More Articles on the Becker's Hospital Review Annual Meeting:

5 Key Financial Ratios Healthcare Providers Should Track

What is a Healthcare Leader Worth? Determining Hospital Executive Compensation

The Most Common Medical Staff Problems and Issues and How to Handle Them

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