THE BIG PICTURE

Radiology's Next Move
By Curtis Kauffman-Pickelle

Imagine the situation facing radiology practices and their changing market relationships as multiple, concurrent chess matches. In order to reach a respectable outcome without getting swept away by the convergence of moves coming in rapid succession from prepared opponents, radiologists need to understand that this particular game is strategic, not tactical.

To succeed in a newly complex health-care environment, practitioners will need to understand that a good strategy is not simply a collection of tactics—an exhaustive list of projects and things to do—that provides a semblance of momentum. Although it's comforting to work through a nice roster of tasks and to-do lists, it is no substitute for managing assets in a way that moves your organization toward realizing a strategic vision of its future. Marshalling resources and deploying them through effective leadership transcend the rather ordinary process of working through a series of projects.

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Business 101: Overcoming Tyranny of the Majority
By Cat Vasko

As radiology practices nationwide look for new revenue streams to compensate for ever-declining reimbursement, the answer might be getting back to basics, according to Greg Thomson and Dan Simile Jr of Medical Management Professionals, Inc (MMP), Atlanta, Georgia. In the first installment of a four-part series on critical business principles, Thomson and Simile outline three ways in which practices can improve the effectiveness of their operations: goal setting and strategic planning, execution of goals, and communication and information sharing.

"If you do not have a business approach when dealing with the operations of your practice, you will be paralyzed. You will not be able to set goals, and even if you do communicate, you will get bogged down in areas that should not be the focus of the group."

—Dan Simile Jr, MMP

Radiology groups, which are typically run as democracies, must face the twin problems of tyranny of the majority and obstructionism of the minority, Thomson warns. Because the principals in radiology practices are all professionals, it is difficult for leadership to emerge. He says, "Everyone is equal, and nobody wants to tell anyone else what to do, and it leads to inaction and apathy. Each physician may have a slightly different goal, and typically there is not a lot of communication in terms of setting goals, sticking to them, and measuring the results."

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Deadline 2012: MRI Accreditation
By George Wiley

Under the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, those sites providing the technical component of advanced imaging must have accreditation by 2012—but not all imaging centers are waiting for the deadline. A case in point is that of the Frye Care Outpatient Imaging Center, which is operated by the Frye Regional Medical Center, a 355-bed private hospital in Hickory, North Carolina.

Frye Care decided to become accredited early so that it would be ahead of the curve, according to Pamela Barbour, the outpatient center's supervisor for mammography, MRI, and ultrasound. It also wanted to meet mandates from insurance companies for accreditation and to prepare for any new quality-control initiatives that might flow from health reform, Barbour adds. The way that Frye Care accredited its newly purchased MRI unit opens a window on the accreditation process and demonstrates the role that vendors can play.

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Enterprise Image Management: Bringing Cardiology Into the Fold
By Cat Vasko

Harris County Hospital District (HCHD) is the public health-care system for the nation's third most populous county (Harris County, Texas); with 44 locations, it generates 420,000 radiology procedures and 70,000 cardiology procedures each year. When HCHD made the decision to expand its electronic medical record (EMR) to include PACS and other ancillary applications, Anwar Motan, manager of IT for clinical and ancillary systems, knew it was critical to integrate cardiovascular applications and images into the system.

"Through expanding the radiology PACS, we realized we could consolidate most of cardiology as well," Motan explains. "The cardiology department had several different applications, and there was no single area for filing its images. It was a known issue for the cardiologists, and for us, it was a nightmare to support, so we decided to bring in the cardiology modules to give us a single view for everything."

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Teleradiology Providers Open the Door to Cost Savings
By Julie Ross

Community hospitals, like their larger counterparts, continue to encounter financial challenges as they strive to deliver cutting-edge imaging services. For some institutions, engaging a full-service teleradiology provider could result in cost savings.

In a white paper produced by Franklin & Seidelmann (Beachwood, Ohio), the national teleradiology provider lays out a matrix of hospital costs associated with providing an uninterrupted radiology service and identifies areas of potential savings that can be captured through contracting with a teleradiology provider for full-service coverage, including final interpretations. Although the paper does not include any details on the costs of the teleradiology service, it does provide food for thought for community hospitals seeking an alternative to their current radiology-service providers.

Most system investments in radiology contribute to a key workflow step in the process of delivering imaging services. By electing, instead, to contract with a teleradiology provider for full-service coverage, a hospital will be able to transfer responsibility to the teleradiology company for all of the systems needed to read the study and dictate, transcribe, and communicate the results (Figure 1).

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Study: Imaging Improves Health Outcomes
By Rich Smith

Lower mortality rates are among the benefits delivered by diagnostic imaging, according to a study in the December 2009 issue of the Journal of the American College of Radiology: JACR. The study—by David W. Lee, PhD, of GE Healthcare (Waukesha, Wisconsin), and David A. Foster, PhD, of Thomson Reuters (Ann Arbor, Michigan)—examines the association between the utilization of inpatient diagnostic-imaging services and key hospital outcome measures. The authors find that imaging yields value and therefore should not be curtailed, whether by reductions in payment rates or by limitations to access through certificate-of-need programs and other artificial constraints.

Moreover, Lee and Foster observe that imaging studies contribute to improved patient care—including lower mortality rates—with no attendant increase in health-care costs. The study provides imaging providers with scientific data to counter government efforts to curtail utilization by ratcheting down reimbursement.

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PUBLISHER
Curtis Kauffman-Pickelle

EDITORIAL DIRECTOR
Cheryl Proval

EDITOR
Cat Vasko

ADVERTISING DIRECTOR
Sharon Fitzgerald

PRODUCTION COORDINATOR
Jean Lavich

TECHNICAL EDITOR
Kris Kyes

WEB MASTER
Robert Elmquist

CONTRIBUTING WRITERS
George Wiley
Julie Ross
Rich Smith

Physician-payment Cut Forestalled
On March 2, the Senate voted 78 to 19 to pass HR 4691, which delays the Medicare physician-payment cut mandated by the sustainable growth rate (SGR) until April 1. Discussions continue in the House and Senate as to appropriate next steps for addressing the Medicare payment crisis; one proposal would implement another short-term SGR patch for 90 days, while another would delay the cuts through the end of 2010.

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A Closer Look at Hospital Contracts
An article by Lawrence R. Muroff, MD, in the most recent issue of the Journal of the American College of Radiology: JACR looks at how and why radiologists lose their hospital contracts, including carveouts and turf erosion, and provides suggestions for avoiding this situation. "First and foremost, radiology is a service specialty," Muroff advises. "Radiologists must be visible and available in their hospitals, and they must embrace their roles as consultants."

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Hospital Reports Brachytherapy Error
According to a report filed recently by the University of Pennsylvania Hospital, a patient implanted with 65 radioactive seeds as a treatment for prostate cancer received a follow-up CT during which physicians discovered that the seeds had been implanted in the wrong area. Hospital officials say that a malfunctioning ultrasound machine is to blame. In response, the Pennsylvania Environmental Protection Department has issued a recommendation notice advising radiology providers to reevaluate equipment calibrations, develop and adhere to proper protocols, and ensure appropriate staff training.

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MARCH

Imaging 100
Sponsored by Lincoln Healthcare Events

March 20–23
Chateau Elan Golf Resort and Winery, Braselton, Georgia

Highlights of this 2010 executive program include programs on controlling the influence of radiology benefit management companies, attracting private equity to your OIC, building successful hospital-imaging center partnerships, and fostering customer loyalty.

[Register]

2010 Congress on Healthcare Leadership
Sponsored by the American College of Healthcare Executives

March 22–25
Hyatt Regency Chicago, Chicago, Illinois

The 2010 congress will focus on professional development for health-care leaders, with over 100 educational seminars, special programs, and networking events.

[Register]

APRIL

19th Annual MRMS Educational Conference
Sponsored by the Magnetic Resonance Medical Society

April 24–28
Omni La Mansion del Rio, San Antonio, Texas

Topics run the gamut of MRI management, from reducing avoidable errors and infection control to accreditation and appropriateness, in addition to motivational sessions.

[Register]

MAY

International Symposium on Multidetector Row CT
Sponsored by the International Society for Computed Tomography

May 18–21
Hyatt Regency, San Francisco, California

The 12th annual symposium will feature focused 10-minute lectures from 65 international speakers; the conference will also include the eighth annual Workstation Face-Off.

[Register]

2010 Radiology Summit
Sponsored by the RBMA

May 23–26
The Broadmoor, Colorado Springs, Colorado

RBMA's annual meeting of radiology business professionals will feature extensive educational sessions presented by industry leaders, allowing attendees to share business challenges and solutions.

[Register]

PRESIDENT/CEO
Curtis Kauffman-Pickelle

VP, PUBLISHING
Cheryl Proval