8 Ways to Boost Radiology Practice Efficiency in 2014

December 11, 2013
Deborah Abrams Kaplan

Do you resolve to make your radiology practice more efficient in 2014? We talked to the experts to bring you eight ways to boost efficiency – without breaking the bank.

Do you resolve to make your radiology practice more efficient in 2014? We talked to the experts to bring you eight ways to boost efficiency – without breaking the bank.

1. Only use final reads.

Radiology groups using nighttime coverage services or relying on the emergency physician to do preliminary reads may be causing themselves extra work. “Lots of radiology groups use nighthawk type services to maintain control of night-time reads, having them do prelims. And they come in and do final reads in morning. That’s not a very efficient workflow,” said Teri Yates, founder and principal consultant of Accountable Radiology Advisors in Ohio.

Radiology groups fear that allowing the nighttime service to do final reads weakens their position and puts contracts at risk, which is a legitimate concern, she said. But using preliminary reads from others increases communication problems if discrepancies are found by the radiologist providing the final read. In emergent cases, the patient may already have been treated and sent home. “Sometimes that discrepancy doesn’t get effectively communicated,” to the patient, Yates said.

2. Use voice recognition with self-editing.

Voice recognition software allows you to get your thoughts down quickly. But don’t wait for a third party to edit your work. “By self-editing it on the spot, you get the report out right away,” said Yates. “When a group converts to voice recognition and 100 percent self-editing, turnaround time becomes very fast.” With this method, radiologists can finish a read and report within 30 minutes, which means that the ordering physician, like an emergency physician, doesn’t feel the need to do a preliminary read.

3. Opt for structured reporting.

Automation and technology can boost efficiency with structured reporting, and there’s less dictation needed. Also, those who use it make fewer errors. “Think of it as a diagnostic check list,” said Yates. If reading a chest CT scan looking for a pulmonary embolus, you’re obligated to look at everything in the chest, not just for the embolus, said Yates. With structured reporting, a template or checklist guides you through the reporting and dictation process. Templates can populate predetermined phrases and the structure makes sure the radiologist comments on each area, hopefully with consistent language. This is helpful to the referring physicians, said Yates, because they’ll see the same system order every time.

4. Rely on automated communication of critical findings.

Following up with referring physicians about critical findings “is a very time consuming process for radiologists,” said Yates. It can disrupt the reading workflow, and if the referring physician isn’t available, there needs to be a tracking system so it doesn’t get lost.

Multiple software solutions integrate with dictation systems, or are standalone systems, said Yates. Paper logs used by some radiology practices are not efficient. Using software, a radiologist can launch the tool when needed to enter the finding on a work list, and this item needs to be checked off before it’s removed from the electronic list. Some systems populate the referring physician’s contact information or tell the administrative aide to reach the doctor by phone. Some systems allow information to go by text or smartphone application.

Once communication is made, the software system can put a statement on the radiology report, noting the time that results were communicated.

5. Adopt rule-based scheduling.

Radiology offices often have many different rules when scheduling an imaging exam. Examples might be that the office can’t do a diagnostic mammogram on a certain day because there’s no radiologist available to read it, or the imaging machine is reserved for research, so it’s unavailable at that time for a patient exam.

“One of the biggest failures I see is when people make those rules and they’re not built into their scheduling system, and it’s dependent on someone remembering it,” said Irene Vergules, a Philadelphia healthcare consultant specializing in call center technology. “We push to make sure the system they use to schedule is as closely reflective of the rules of their department. This way there’s less error, and the patients are properly scheduled.”

It can be as simple as making sure schedules are constantly maintained in the computer system. “If you can’t do a contrast study in the evening, don’t let the system offer those time slots,” she said.

6. Use scheduling software fully.

Most offices don’t use scheduling system software to its full capacity. “Push your system to the limits and figure out what else the system can do for you,” Vergules said. That might be using modifiers to determine if a study should be longer or shorter.  Learn what the system can do by contacting user groups or asking other organizations about their use of the same software. “Ask those challenging questions,” she said.

7. Team up.

Even if your organization is small, you can share best practices, quality initiatives and even gain financially by teaming up with like-minded groups. An example, said Yates, is Strategic Radiology, a consortium of 17 large radiology practices that banded together partly for economic advantages as a group purchasing organization.

“They said they can be more efficient and effective if they work together,” she said. The practices are independent, but share data, which helps them lower practice costs by seeing how similar organizations are run.

Most radiology groups in county have 10 persons or less, said Yates. “An eight-person group has the same basic needs as a 100-person group,” she said. Due to small scale, individual practices may not be able to afford some of the resources of larger organizations, but by banding together they work together to meet some of those needs.

8. Make it easy for patients.

Especially when growing a practice, make sure your hours of operation aren’t restrictive, so that patients can reach scheduling staff or get appointments at times reasonable for them. “Some places close for lunch or open only 8 to 4. It’s hard for some people to call during those hours,” Vergules said.

This involves knowing your population and your location restrictions. “Depending on where you live, some people wouldn’t go there at night or on weekends,” she said, due to safety issues. For other facilities, nights and weekends are an efficient use of imaging time.

When scheduling a study, make it as simple as possible for the scheduler and the patient by asking only the right screening questions. “Some places don’t ask enough screening questions, and some ask way too many,” Vergules said. Ask the deal-breaker questions when scheduling the exam, she said, such as if the patient has a pacemaker. Questions about age, heart disease and other medical history make sense to ask when the patient arrives, but may not be necessary for scheduling. Asking only the pertinent questions, she said,  “make it as seamless as possible.”

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