Sham Sokka

Today’s radiologists are being asked to work more efficiently against the rising pressure of increased imaging volume, growing complexity of cases, and fewer resources. The result of this intensified workload is a modern-day epidemic where approximately 

 in the U.S. are experiencing feelings of burnout.

In addition to being overworked, radiologists are also operating in an age of heightened consumerization of healthcare; patients’ expectations for convenient and customized care delivery are mounting every day. These demands not only jeopardize a radiologist’s wellbeing, but also the healthcare system itself. 

. With remote interpretation of patient images from medical imaging studies, such as CT, MR, and X-ray exams, radiologists don’t need to be in the same location as the patient. The global teleradiology market is among the fastest growing segments in radiology and the clinical services outsourcing market, and is expected to be a sizable part of the imaging interpretation market within the next few years.

Now, the term “teleradiology” is more accurately described as “virtual radiology” as we’re seeing the clinical services outsourcing business model move from being used mostly for off-hours, subspecialty areas, or individual imaging remote procedures to enabling a 24x7 connected, comprehensive and cost-effective global approach both within a network and outside that is transforming delivery of care.

Virtual radiology not only empowers radiologists to manage their case load remotely, but also offers patients the convenience they seek to access care when and how they prefer. Furthermore, for those patients who may not have access to advanced imaging technology or the expertise they need, virtual radiology supports quality standardization across the care setting-no matter where a patient is located. With this expanded virtual radiology approach, the industry has the potential to improve job satisfaction to reduce burnout, create better access to advanced diagnostics, and enable a universal standard for diagnostic imaging for all patients across the world.

Driving a Seamless Virtual Radiology Network with Artificial Intelligence

In the U.S., the continuing consolidation of hospitals is now necessitating a similar merger of radiology practices who can now better deliver services remotely. Powered by artificial intelligence (AI), virtual radiology enables providers to increase their imaging volume while maintaining quality. A virtual or tele-radiologist can take on more image reads and consistently interpret them in a shorter time with quality results. AI helps automate these tasks and prioritize the most urgent cases. Ultimately, this will help alleviate the mounting pressure radiologists are under – by offering the ability to interpret images remotely – radiologists can do so on schedules and locations that work best for them.

The rise of AI signals our industry’s transition from a focus on siloed solutions to integrated platforms that supports a radiologist’s existing workflow. As a key driver behind virtual radiology, AI helps augment the radiologist’s knowledge and capabilities and improve connectivity, while reducing human error through enhanced imaging assessment. With the support of AI algorithms, it’s possible to acquire high-quality images during the first scan for review remotely, accelerating workflows and ultimately treatment. Using AI, health systems can also recognize a radiologist’s availability, and re-route a case to the next expert in the queue if needed, for example.

By combining efficiency, quality and AI, virtual radiology allows radiologists to focus on making a confident diagnosis and less on technical processes. With fewer secondary or delayed scans, radiology administrators can also focus more on strategy, such as maintaining quality or reducing cost per diagnosis. This helps drive a seamless virtual radiology network, linking providers together with patients regardless of location.

Achieving a universal standard of diagnostic imaging

In addition to the benefits for imaging staff, virtual radiology has the potential to transform healthcare by providing access to diagnostic services and medical expertise to people in areas around the world that need it most. According to global market analysis conducted by Transparency Market Research on behalf of Philips, the global teleradiology services market was 

 and is estimated to reach $21.8 billion by 2026. This growing trend will impact patient access in both developed and developing healthcare markets. In developing markets, virtual radiology makes advanced imaging technology and the expertise of radiologists practicing at the top of their license accessible to underserved regions. In developed countries, virtual radiology helps standardize the quality and access to care no matter where patients are, including imaging quality, protocol and diagnostic outcome.

In addition to level-setting care, virtual radiology will help radiologists adapt to the unprecedented influence patients have as consumers of healthcare. Patients can have direct access to radiologists, and speak with them via video-conference to gain clarity on their diagnosis or treatment plan. Virtual radiology also gives radiologists the ability to monitor and engage with patients more meaningfully. This is particularly important for patients with complex health challenges, such as cancer or neuro-degenerative diseases, whose care path is fluid and whose treatment effectiveness is assessed more frequently. By providing new avenues for patient interaction and proactively addressing any red flags before they escalate, radiologists will regain some of the human-interaction that can make their job rewarding, and patient care will reap the benefits.

Transforming healthcare delivery in the future

 as the largest growing healthcare outsourcing sector, with 90% of providers considering outsourcing in 2019, an increasing amount of healthcare professionals are realizing the benefits of virtual radiology for both themselves and their patients. Rather than being tied to a particular hospital or anxiously waiting for results from their primary care doctor, patients will have the option to have their images reviewed by top-level physicians no matter where they are. This also offers the radiologist flexibility in their workload, helping to keep burnout at bay. 

Radiologist burnout is as alarming as the diseases we treat patients for and deserves the same attention. By activating a more cost-effective, efficient path to diagnosis and treatment, virtual radiology helps democratize care and support the imaging staff that delivers it. With a broader view of the transformative nature of teleradiology, we can reduce radiologist stress, improve the speed and accuracy of image interpretation, and facilitate collaboration among clinical care teams globally while providing a strong platform for future growth.

Sham Sokka is marketing leader, Precision Diagnosis at Philips

Articles

How the technology is helping address burnout while delivering comprehensive, connected care globally.

Tackling Radiologist Burnout through Teleradiology 

No one likes a “no-show.” We all know the frustration when we expect someone to arrive and they don’t. The waiting. The time lost. The wondering. In healthcare, patient no-shows, or missed medical appointments with no prior notice, are prevalent-and costly.

The size of the problem in radiology is particularly burdensome with rates ranging from 4-40%, and an estimated $300 to $400K of uncaptured revenue per year in certain modalities. While these statistics may not be surprising, they are problematic.

Recognizing the impact of patient no-shows

The three main impacts of patient no-shows in radiology are uncaptured revenue, underutilized staff and resources, and delayed patient care. The high rate of patient no-shows is a big concern in imaging due to cost and efficiency-imaging exams are expensive compared to other medical appointments and require highly-skilled staff to perform them.

The lost revenue opportunity and workflow, and equipment utilization for radiology departments is also significant. Beyond the more obvious financial impacts, patient no-shows have clinical ramifications as well. Imaging exams are usually ordered when a patient’s condition has reached a more serious stage or doctors need to identify more clearly the root cause of concern. When patients don’t show up, it delays a definitive diagnosis and possible treatment, which affects patient care.

Unfortunately, most hospitals or imaging centers don’t usually have a good answer as to why patients don’t show up for appointments. Possible explanations range from patient anxiety about the exam or diagnosis; to employment, marital, or insurance status; to the number of past visits and familiarity with the hospital.

Other uncontrollable variables that attribute to patient non-compliance include things as simple as busy schedules, forgetfulness, driving distance, or the weather on the day of the exam. There are so many variables, many of which can be unique to a particular hospital’s demographic area or particular situation, that it’s difficult to pinpoint.

There are some ways to better understand patient no-shows. Using 

 and radiology information systems, providers can track which patients didn’t show up for appointments and determine if patients were double booked at another site in a multi-site organization. They can also identify what types of imaging exams have a higher rate of no-shows, or track how many patient no-shows they had each month or year. However, these tactics only provide insight on a small part of the problem.

To better understand the patient-no show issue, Philips worked with the 

 (UWMC) looking at data from nearly 2.9 million outpatient imaging examinations during a 16-year period to produce 

 that was published in JACR in 2018. Overall, the results of the research revealed that predictors of patient no-show rates are multi-dimensional but generally fall into three main categories each with their own set of unique variables:

 – including age, gender, city of home address, and estimated income

 – such as exam type, duration, department, subspecialty, site of exam, and whether or not the exam requires sedation

 – depending upon lead time, day of week, hour of day, and whether the exam was manually scheduled or not.

One of the most significant correlations for imaging patient no-shows can be attributed to appointment scheduling lead time. If an appointment is scheduled for less than two weeks away, patients are more likely to show up. However, if an appointment has a long lead time, patients are less likely to show up.

For UWMC, based on just a few common imaging exams (breast US, brain MRI, abdomen US, MG screening) the estimated uncaptured revenue from patient no-shows 

 to approach $700,000. The research validated the financial burden of missed appointments for multi-site organizations such as UWMC, while illuminating key insights that might be extended to other institutions.

Identifying ways to reduce patient no-shows

To accurately reduce the impact of patient no-shows, healthcare providers must first focus on getting operational intelligence about the issue by investigating what the extent and implication of the problem is in their particular hospital or imaging center. What works for one hospital doesn’t always help at another-especially if patient populations differ. However, there are a few general areas that radiology departments can focus on immediately to increase patient compliance.

Scheduling systems can make the process more automated and assign appointments to patients based on risk level-meaning patients with a high risk of not showing up can be scheduled later in the day when a no-show would have less impact on workflow and other patients. Reminder systems can also increase compliance, but the means of communication must be tailored to specific patient lifestyle to be effective.

What To Do About Patient No-Shows at Your Radiology Practice

Improving the overall patient experience in imaging goes a long way too. This includes keeping patients informed, communicating in advance about the procedure, and helping them prepare mentally and physically for the process.

Utilizing data analytics, AI to predict no-show rates

Most importantly, hospitals or imaging centers need to realize that individually, these variables or predictors are not enough to effectively predict patient no-show rates-but 

 they can be very informative. This is where data analytics tools, predictive modeling, and 

 can be most helpful. Based on the variables and other types of data such as age, gender, or demographics, predictive modeling and data analytics tools can help us predict 

 it is that a particular patient will show up for an appointment.

For instance, to predict no-shows and cancellations, providers must first accurately capture all the potential factors that might affect no-shows. With the right data captured and artificial intelligence applied, we can close the gap by aggregating large volumes of retrospective data, demographic data, and census data. We can then construct quantitative models to predict no-show occurrence and highlight features that are informative in the prediction.

Minimizing patient no-shows in your own institution

If we look at the issue of patient no-shows from a strategic value-based care perspective, it is easy to see the ripple effect it can create for imaging departments. When patients don’t show up for appointments, it takes away an opportunity for another patient to have an exam done that day, and it puts the patient who doesn’t show up back in the queue, thereby extending the waitlist for other patients and delaying care.

Simple Methods to Reduce No Shows at Your Medical Practice

No-show prediction in radiology has the capability-through scheduling interventions and strategic patient engagement-to recapture revenue that would otherwise be lost to empty appointment slots. Awareness of the issue is the first step, identifying root cause is the next. When healthcare providers can readily see the actual data on the impact of missed appointments, as well as understand the unique patient-population or modality-specific trends within their own institution, they are in a better position to act with imaging data analytic strategies that provide tangible returns.

Sham Sokka is head of radiology solutions and Christopher S. Hall, PhD is the senior director of advanced concept development, radiology solutions at 

Missed appointments can have serious consequences for patient outcomes-and for your bottom line. Here are some strategies for reducing the number of no-shows.

Author | Sham Sokka

Articles

Tackling Radiologist Burnout through Teleradiology

How to Minimize the Impact of Patient No-Shows