Tracking and Providing Data for Practice Improvement

February 3, 2011
Richard Woodcock, MD

Everyone I know, radiologist or otherwise, looks forward to getting their paycheck. And most of them want to look at it as soon as it arrives. It is therefore a powerful tool for delivering information, since it commands attention. So what information can be conveyed? Metrics of several types are a good option.

Everyone I know, radiologist or otherwise, looks forward to getting their paycheck. And most of them want to look at it as soon as it arrives. It is therefore a powerful tool for delivering information, since it commands attention. So what information can be conveyed? Metrics of several types are a good option.

First, as a practice you should decide what you want to value, track, and improve. An easy place to start is the number of studies read and RVUs (relative value units). Since radiologists have such heterogeneous jobs, data of several types should be provided. By providing data for RVUs and studies read, both high-volume/low-RVU providers and low-volume/ high-RVU provider are more clearly depicted.

RVUs are a debatable measuring stick in all medical disciplines. In radiology they may be more so, given that some have suggested they advantage procedural CPT codes in radiology practices and some complex imaging.

Moreover, with current payment arrangements, RVUs may represent work, but not necessarily financial value to the practice. Specifically, some codes are associated with high RVUs but may be subject to payer exceptions or significant adjustments especially in radiology. Given that, some practices also include dollars collected and dollars collected per study to give a clearer picture of direct financial impact on the practice by provider.

Another means of separating the data is to add more detail on types of studies read. This can better compare similar job types.

For financial data, year-to-date performance is a helpful adjunct. It can be listed with historical comparisons and even with annualized projections if desired.

Many practices may want to include performance measure of quality, if you or your hospital tracks those, such as turn-around time, sign-off time, or time to communicate critical results.

Remember that not everyone wants all data shared publicly, and not everyone may be used to or comfortable with comparing themselves this way, for many reasons. Some may not believe that public comparison is an incentive. Some may feel the data may be an inaccurate representation of work provided. Others may feel it is not appropriate to measure physicians this way. But for most businesses outside medicine, this is a typical procedure and instrument for assessing productivity and providing incentives.

It is important that your practice discuss this and decide -as a group - how to share the data. To preserve anonymity, individual data can be compared to practice averages, listed with a rank order or listed with comparative anonymous listing of other providers’ data.

Like any other new addition, transparency of purpose and general agreement on form goes a long way in making sure the new process is smooth and received well. Regular communication of such information may also clarify differences or similarities among providers, provide incentives, or assuage concerns depending on their results.