Top 10 hospital needs from radiology

For most radiology practices, the customer is the hospital or health system they serve. To ensure long-term success in this relationship, practices must gain an understanding of their customer's evolving needs while providing proactive solutions that help address them. It is no longer feasible for radiology to take a passive role with medical staff and hospital leadership.

 While no two markets served by a hospital are exactly alike, there are some universal wants and needs hospital C-suites seek from their radiology partners. Here are 10 such wants and needs radiology practices should know to build stronger, lasting relationships with their hospital customers.

1. Alignment with hospital strategic imperatives and initiatives. It is imperative for hospital and radiology leadership to have a shared understanding of health system strategic imperatives. Radiologists need to know the hospital's service delivery direction throughout the continuum of care and how they “fit” into the strategic imperatives. This should comprise both inpatient and outpatient care and any other outside entities incorporated into the delivery network.

When there are open channels of communication between hospital and radiology leadership, and open dialogue about a hospital's objectives, radiologists are in a better position to bring innovations and solutions consistent with the hospital's strategic imperatives.

While hospital and radiology leadership may not always agree on the exact path to these results, what's important is that through consistent communication, the desired outcome is achieved.

2. Quality metrics to differentiate the hospital from competition. A hospital's performance in delivering quality care is measured in a variety of ways, depending on their various stakeholder needs. These include participating in certain third party payer networks and providing patients with differentiating metrics for review. As emerging payment mechanisms show us, there are often financial benefits tied to achieving certain quality objectives.

Radiologists need to explore different programs and processes for measurement and continuous improvement to demonstrate clinical quality. Together, radiology and hospital leadership need to collaborate to determine the quality metrics — measures of radiology success — and how they can be utilized to contribute to the endgame of better population health through the delivery of cost-efficient care.

When radiology delivers measurable, high-quality services, the hospital is able to use quality achievements to its strategic advantage.  The radiology group itself can be a differentiator for the hospital in the community.

3. Utilization management to avoid duplication of services. Hospitals are measured on how efficiently services are utilized. Radiologists are uniquely positioned to help eliminate waste and duplication while also identifying areas for better ordering physician education and resource allocation.

Since radiologists provide services inside and outside the hospital setting, they possess a broader view of service utilization. With this insight, radiologists should work to determine how utilization of services is managed throughout the continuum of care and what can be done collaboratively with the hospital to improve efficient and appropriate use of services.

Hospital and radiology leadership should examine how the use of technology and effective protocols in patient treatment can minimize duplication of services. In addition, leadership should work to find patterns and identify areas where radiologists can help educate ordering physicians on appropriate use of diagnostic imaging.

4. Increased service coverage and sub-specialty access. Over the past several years, hospital and medical staff leadership have increasingly valued radiology group service coverage throughout the continuum of care. Today, the "standard" radiology group practice service delivery expectation has become 24/7/365 availability of radiologists, as well as an increasing expectation of deep and broad sub-specialist availability in all service locations.

Hospitals desire to deliver to patients and referring physicians easy and fast access to services, as well as quick imaging study results performed to assist in accurate diagnoses and treatment of patients. The "tension" presented to the radiology groups to provide superior and differentiating service levels, in addition to the ability to attract and maintain a cadre of sub-specialty trained specialist physicians, is the cost of doing business so.

More radiology groups look to colleagues in other practices to with whom they can collaborate and integrate so they can gain the scale from one another more effectively than they could on their own. Through joint venture networks, independent radiology groups are discovering innovative ways to provide high-quality professional services while collaborating to contain costs and improve the performance and satisfaction of all members.

It is also important for hospital and radiology leadership to work closely toward a balanced approach that meets the medical staff needs and demands while containing costs.

5. Improved patient satisfaction. Most patients can name their primary care physician and usually a few other physicians. But most patients probably cannot name their radiologist because, historically, patients and radiologists rarely saw each other. But that's quickly changing.

There is more patient interaction with radiology, particularly in areas such as women's imaging and minimally invasive procedures. As interaction increases, there is greater opportunity for radiologists to influence patient satisfaction scores.

For many payers and other quality rating agencies, patient satisfaction is a very important metric. In addition, as patients bear more financial responsibility for their care, they are naturally becoming more selective of who provides their care.

Radiologists and hospitals need to determine how to continuously obtain patient feedback and ensure positive patient experiences. If they fail to put such mechanisms in place, patients will find someone else to deliver their care.

6. Improved medical staff satisfaction. Satisfied medical staff usually translates to more satisfied patients and better quality care. In addition, staff satisfaction is important for the hospital from a medical staff alignment perspective. Satisfied ordering physicians will continue to utilize those service providers who deliver results and value collaboration.

As with many other healthcare services, physicians who are trying to determine the underlying cause of a healthcare problem want and expect timely test results. As noted earlier, radiologists are expected to deliver fast turnaround times and thorough results.

To ensure medical staff needs are met, radiologists must work closely with hospital leadership on developing good communication mechanisms with ordering physicians. Such collaboration will help radiologists know when urgency is needed; when physicians are unaware of technology options that may be more appropriate for evaluating clinical issues; and when new studies support different testing decisions.  

7. Consistent imaging service delivery. There is evidence that consistent imaging services — following the same common clinical protocols and approaches to patient treatment — can minimize unnecessary use of resources while improving efficiency.

It is vitally important for radiologists to aim to achieve such consistency. Many groups are evolving in how they integrate and collaborate with other radiology groups. When this occurs effectively, it can lead to common protocols and shared best practices across the entire health system.

The result: improvements in efficiency and development of service uniformity across the entire enterprise, which bodes well for radiologists, hospitals, patients and payors.

8. Shared risk in emerging healthcare payment initiatives. Payment mechanisms are changing. While fee-for-service is not going away anytime soon, there are emerging payment mechanisms (e.g., bundled payments, episode of care payments and value-based payments) that will likely call for providers to assume some financial risk.

Hospital and radiology leadership should examine these emerging payment mechanisms and discuss work together to understandhow to assume risk — manageable risk — together. An important component will be sharing and examining data showing the cost of providing services that deliver optimal outcomes to patient populations.

When informed decisions are made based on such business intelligence, hospital and radiology leadership will find themselves ready to engage in future risk-sharing, risk-based contracting.

9. Strong physician/hospital partnership. To truly serve as a hospital partner, radiologists need to come forward with information and innovative solutions. Radiologists must participate — and sometimes initiate — conversations about how to bring about a collaborative outcome that makes the hospital the preferred healthcare delivery service throughout the continuum of care for a broad spectrum of the patient population.

There will be times when hospital and radiology leadership disagree about an approach to take or issues that need resolution, but what's more important is for both parties to never waiver from a willingness to sit down to collaborate, innovate and achieve the best solution.  

10. Positive contributions to the "hospital brand." Customer is a difficult word for many physicians to accept, but once radiologists can view the hospital as a customer, they are more likely to develop an appreciation for improving customer satisfaction.

A significant part of hospital leadership satisfaction is seeing positive building of the hospital's brand. Radiologists must learn to appreciate the importance hospitals place on their brand, and bring forth solutions that will contribute to the brand and allow the hospital to shine. This will yield benefits for both parties.

Take the initiative
The key for radiology leadership is to engage hospital leaders and then "peel the onion" to uncover their most critical present and future needs and priorities. The key for hospital leadership is to engage radiology leaders and invite them “to the table” to assist in bringing forward to their communities a differentiating message and demonstrating “why us”.

Once accomplished, radiology groups and hospitals can make informed decisions, contribute to their shared strategic imperatives and bring forward innovative solutions to become and be perceived as valuable, more proactive partners.

Douglas Smith, FRBMA, is managing partner of the Strategic Positioning and Consulting Solutions division of Integrated Medical Partners, LLC, a national medical practice service support and consulting organization, as well as Integrated Radiology Partners, a subsidiary focused exclusively in the radiology sector, both headquartered in Milwaukee.   Mr. Smith spent over six years as president of the healthcare consulting group of a division of a large CPA firm and 11 years as managing partner and owner of Barrington Lakes Group, Inc. a consulting and practice management firm with specialized expertise in diagnostic imaging services. Barrington Lakes Group merged with Integrated Medical Partners in 2011.

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5 common misconceptions about hospital purchased services
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