Know Thy Competition

August 24, 2015

Be prepared for your biggest radiology competition.

Is your radiology group stagnant? Has it been slogging along – providing adequate service that lacks differentiating features? What about apathetic? Or inertia-ridden? Are these adjectives synonymous with your group?  Perhaps there is a better way to frame the question. 

Is your group average? 

It is very hard for people and organizations to admit to being average. And average is a dangerous place to be.

We have heard and read the tales of radiology groups that have fundamentally restructured how they function and provide service. Strategies of co-management, value quantification, and noninterpretive value measurement have been successfully implemented by multiple radiology groups with tremendous success. These groups have restored relationships with hospital administrators and are now excelling. These are valuable stories.

Will other groups follow their lead?  Or will they wait until their jobs are threatened by the hospital? Or when an RFP is sent out by the health system? And even if they were to implement change – what would be the first step? What will be the strategy?

If you and your group are struggling to formulate a cogent strategy - try this. Imagine a radiology group that could move into the region tomorrow and destroy your practice. What would it look like? What weaknesses of your group might this new business exploit to capture their target audience? It is a beneficial exercise because it often illuminates the most glaring shortcomings of an existing practice.

Do you think they would build a business centered on volume – continuously aiming to have every radiologist read 22,000 RVUs annually? Would they consider themselves technologically advanced because they have PACS and voice recognition software? Would they sell themselves to hospitals by emphasizing their ludicrously fast turn-around-time?

Unlikely. Your group already has those bases covered. This new group – “Modern Radiology” – is going to target your weaknesses.

“Modern” will offer convenience. Patients will be able to schedule imaging tests online with online registration and payment systems. Their results will be available quickly – and they’ll receive a text message to let them know when their report has been posted online. The report will be downloadable as a PDF so that they can easily share with other physicians. Patients will also get a copy of their images before they leave their appointment.

See – convenience is more than valet parking. Think about how we interact with the airline and banking industries. That is how patients want to interact with health care. “Modern” plans to exploit this need with readily available software solutions.

Artificial Intelligence
“Modern” recognizes that there is an enormous amount of time that each of us spends each day doing activities that do not require our level of training and expertise. Spending time on these menial tasks negatively impacts the value we can provide for our hospitals and referring physicians. They will exploit this by becoming an early adopter of artificial intelligence in radiology and employ Watson for chest X-rays, musculoskeletal radiographs, and screening mammograms. They have plans, when the technology is ready, to use artificial intelligence for trauma CTs and cancer follow-up cross sectional imaging. This allows “Modern” radiologists to spend time analyzing the perplexing cases and consult on the phone and in-person with referring docs and patients. The visibility of a “Modern” radiologist is exponentially greater than an “average” radiologist, consequently. 

Advanced Practice Providers (APPs)
In a similar move, “Modern” plans to supplement its interventional radiologists with advanced practice providers (when appropriate) to perform some central venous access procedures, percutaneous biopsies, paracenteses, and thoracenteses. APPs will also make “Modern’s” E&M coding revenue more robust – a revenue source that your average radiology group is not tapping into. Consequently, “Modern’s” interventional radiologists spend more time consulting with referring physicians, performing complex procedures, and providing clinical care.

Data and Analytics Infrastructure
The leadership at “Modern” sees an opportunity to negotiate directly with payers to develop some alternative payment models (APMs). They first plan to build a bundled APM for breast imaging, and then plan to roll out a similar program for patients with uterine fibroids. Leadership knows this will require data to design. Costs associated with providing care for these patients must be known. Volume trends are necessary. Money saved should be calculated. And data-driven risk-sharing will be required.  “Modern’s” leadership knows that a robust data collection and analysis system will be needed for this sector of their strategy. Thus, they plan to invest a substantial portion of their budget on software tools and an informatics team charged with becoming a data/analytics leader in the radiology space. 

You get the picture.  By highlighting weaknesses – existing groups can begin to see, with greater clarity, the areas to which energy should be channeled. Do this exercise with your group leadership and build a vision for where you want to take your practice. We can all see it coming.  “Modern Radiology” is moving to a town near you soon. Don’t be left behind when they finally arrive.