By Aine Cryts
At as much as $3 million a pop, a CT scanner is a significant expense for any hospital. The leadership team at East Texas Medical Center Tyler (ETMC-Tyler), a 464-bed community hospital in Tyler, Tex, wasn’t sure they needed to invest in a third CT scanner, so they needed to ask a lot of questions, such as:
- Does our CT volume support the capital purchase of a third CT scanner?
- How do we stack up against best practices among other Level I Trauma Centers?
- If we do invest in a third CT scanner, how soon would our hospital be able to recoup its investment?
Then Dianne Adelfio, vice president of operations at ETMC-Tyler, realized that she couldn’t even start to answer these questions. “We couldn’t glean a clear picture of trends among ordering physicians and times that CTs were being ordered, along with peak days and hours of operations,” she said. What helped Adelfio and the rest of her team make their decision was an analytics tool from vRad, one of the country’s largest teleradiology providers.
Ultimately, ETMC-Tyler did purchase the third CT scanner in May 2014 after a discovery process that took 4 months. With that project completed, Adelfio’s team kept coming up with new questions to ask that could lead to greater efficiencies and better patient care at the hospital. One area of focus was its ultrasound program. As is the case at most community hospitals, ETMC-Tyler’s ultrasound program traditionally ran Monday through Friday, with on-call support during the weekends.
The discovery process included getting “very microscopic” with everything from peak hours to days of operations. To answer their questions, her team needed to determine the hospital’s highest volume days and isolate where the greatest staff needs were. The need to mitigate any type of delays in service to patients and their referring physicians was equally important.
With the intelligence gained from vRad’s solution, ETMC-Tyler changed its staffing plan for its ultrasound program. Today, patients can make appointments Monday through Saturday. There are eight additional slots for patient appointments. In addition to providing better and more convenient service to patients, Adelfio points to reduced overtime costs—that’s $30,000 in just the first 3 months.
And then there’s the issue of patient satisfaction. “Healthcare access is extremely important to consumers,” said Adelfio. “For a person working Monday through Friday, it’s very difficult to get in to have studies done. With imaging studies, patients don’t just walk in the door. First they get checked in, then they get ready, which could mean having to drink a contrast. Patients know they need to prepare to be at the appointment sometimes 2 or 3 hours in advance.”
ETMC-Tyler is using vRad Analytics, a suite of solutions that provides a view into vRad’s clinical database of tens of millions of imaging studies. The solution provides access to user-friendly analytical tools, patent-pending data normalization, national and peer group benchmarking metrics, and access to expert advisory services for collaboration and consulting. It’s because of access to this information, according to vRad, that ETMC-Tyler can “make informed decisions about optimizing staffing, imaging utilization, and clinical quality.”
Driving Change and Patient Satisfaction
Penny Tietz, PACS system manager at Avera McKennan Hospital, a 403-bed community hospital in Sioux Falls, SD, also had a lot of unanswered questions. For Tietz, these questions were about turnaround times for radiology reports. The leadership team at Avera McKennan Hospital wanted to ensure that patients and referring physicians were receiving their results in a timely manner. They set a goal of having radiologists sign off on reports within 24 hours of the image being available for radiologists to interpret.
That time frame mattered because referring physicians needed access to their patients’ images and patients needed to be able to access their own images within the patient portal. To drill down into these turnaround times, Avera McKennan Hospital used Montage Search and Analytics from Philadelphia-based Montage Health Systems. Montage Search and Analytics facilitates the tracking and monitoring of critical results performance to assure a level of service and, “most importantly, to prevent anything from falling between the cracks,” according to the software analytics firm.
Before the hospital set the expectation that patients’ images should be signed off and available within 24 hours, radiologists were typically running 72 hours or as much as a week behind, according to Tietz. To help support physicians, the hospital provided them with additional resources, such as Nuance’s PowerScribe voice recognition technology to facilitate sign-off at home, the ability to sign off on reports on their iPads, and logging in to the Meditech EHR to sign off on the exam results.
To generate reports on this data, Tietz’s team combined the data from Montage Search and Analytics with information generated by their Meditech EHR and their GE Centricity PACS. Tietz says that it takes her team about 5 to 10 minutes to put together each of the reports that are sent out three times a week; reports sent out on a monthly basis require about an hour to put together.
While these reports were once shared with just the head of the radiology department, currently these reports are shared Monday, Wednesday, and Friday with all 21 radiologists on the team.
Tietz’s advice for a radiology department undertaking this type of initiative includes:
- Provide information. Formerly, her team sent reports to the radiology chief only. In order to really hold the entire team of radiologists accountable, all 21 radiologists receive these reports. Ongoing communication by the radiology chief and Tietz’s team also helps to decrease the time it takes for radiologists to sign off on radiology reports.
- Build a relationship of trust with radiologists. She recommends building a relationship of mutual respect with radiologists where radiologists depend on her team to deliver reliable data that informs their work.
- Give radiologists options for signing off on reports. Investing in PowerScribe for home use and allowing radiologists to sign off on reports with their iPads via Meditech or their PACS have all helped to increase turnaround times. Radiologists at other hospitals in the area typically don’t have access to transcriptionists; Avera McKennan Hospital’s radiologists do have access to transcriptionists—and her team reinforces this fact with radiologists at the hospital.
Over the last 2 years, the turnaround time on reports has come way down, said Tietz. “The data’s right there in front of them, and our radiologists work really hard not to be one of the outliers. Some of our radiologists are even logging in to sign off on reports while they’re on vacation.”
Aine Cryts is a contributing writer for AXIS.
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