Outpatient Imaging Center Best Practices Outlined in White Paper
Price Transparency: Movement Gains Momentum Amid Doubts

Outpatient Imaging Center Best Practices Outlined in White Paper

By Cat Vasko

The GE Healthcare white paper emphasizes the importance of proper planning to maximize the potential of a forthcoming boom in imaging use.

“Blueprints for success: How outpatient imaging centers can employ best practices to enhance patient care, transform business performance, and prosper through challenging market conditions,” a new white paper from GE Healthcare (Waukesha, Wis), asserts that outpatient imaging centers (OICs) have much to gain from better business practices. “Despite the challenges of competition and changes in reimbursement rates,” the paper reads, “diagnostic imaging remains a high-growth sector with excellent immediate and long-term prospects.” To that end, the paper outlines four key drivers of OIC performance: technology and capital planning, business planning and finance, marketing and growth promotion, and process improvement/operating efficiency.

1) Technology and Capital Planning

Citing health care consultant Sg2, Skokie, Ill, this section predicts that the volume of imaging procedures in 2005 will double by 2010, with outpatient procedures leading the way. GE Healthcare emphasizes the importance of planning technology acquisition to meet the needs of changing patient populations.

A thorough technology assessment, performed either by OIC staff or in conjunction with outside experts, is strongly recommended; said assessment should begin with an analysis of equipment, taking into consideration such factors as age, condition, software level, current utilization, capacity, projected volumes, and expected replacement dates. The technology assessment is then supplemented with a market analysis, which looks at such factors as demographic data, population growth, future demand, and competition. “This technology assessment helps owners determine how to invest and when,” Marc Cottle, radiology practice manager in the performance solutions consulting practice at GE Healthcare, said in the paper. “It also provides a method to evaluate requests for new equipment—to separate needs from wants.”

The paper also stresses the importance of the three key components of IT infrastructure: the PACS, the RIS, and practice management software. These solutions increase productivity, optimize workflow, and improve customer service.

2) Business Planning and Finance

Adequate working capital is necessary for any business plan, and, in turn, business plans are necessary for securing or changing financing and for guiding management decisions. To address this paradox, the paper discusses some ways an imaging center can build capital: leasing, asset sale and leaseback, leveraging real estate, or securing a loan with accounts receivable.

In analyzing the potential assets, drawbacks, and obstacles to each of these strategies, the paper touches on a few key issues:

  • Location—”The ideal site is close to a major health care provider (hospital campus, ambulatory surgery center, or major medical practice) or to a community with desirable demographics.”
  • Competition—”New centers should not be placed in saturated markets with intense competition, especially if the competitors have strong strategic affiliations for referrals.”
  • Partnership—”Proven partners include hospitals and hospital systems, surgeons and surgical group practices, and specialists who use imaging services in everyday treatment.”

3) Marketing and Growth Promotion

Key marketing contacts are neither patients nor referring physicians, the paper notes. “Ninety-nine percent of all marketing in radiology lies in developing and maintaining relationships with referring physician office staff schedulers,” said Evan Leepson, a senior consultant in the performance solutions consulting practice at GE Healthcare.

To better build these relationships, the paper recommends an emphasis on service: scheduling with no waiting on hold, using real personnel as opposed to an automated phone system, preauthorizing examinations with insurers to save the physician office the trouble, keeping forms simple, delivering reports quickly and without prompting, and providing all the basics for the patient—examination preparation instructions, useful phone numbers, and directions.

The paper also suggests a “spa-like environment” to put patients at ease, noting that word of mouth travels both between patients and back to referrers. And education of referring physicians is not to be discounted: The paper offers such methods as sending educational mailings about new technology, holding demonstrations at the imaging center, offering courses for CME credit, and visiting physicians to display relevant case studies.

Finally, the section notes, the need for effective advertising—”art as well as science”—makes having marketing staff or retaining an ad agency crucial.

4) Process Improvement and Operating Efficiency

CT Room Cycle Time
MRI Room Cycle Time
Data represents all brands and models of CT or MRI systems.

“Patient throughput,” the paper reads, “is the key variable in imaging center performance, and many centers operate far below their potential. Even the best can generally improve.”

GE Healthcare’s white paper offers multiple benchmarks for best practices, providing imaging centers with the opportunity to assess factors, such as MRI and CT cycle time.

In this section, which focuses on operational issues like leadership and workflow, the importance of the employee is stressed. The employee should feel trusted and empowered, with the ability to stop operations to address concerns. “The staff must be equipped with tools that help them eliminate inefficiencies and deal with market influences,” the paper states.

Workflow also is addressed. Some common obstacles cited by the paper include schedule backlogs, slow report turnaround, long patient wait times, inefficient use of protocols, missing or incomplete examination orders, patient transport issues, late or no-show patients, and inefficient hand-offs between shifts. Ameliorating these issues can be both time-consuming and costly. In fact, research from the Healthcare Distribution Management Association, Arlington, Va, claims that errors and exceptions on invoices can cost $15 to $50 apiece to address.

To facilitate workflow, the paper recommends shadowing a few patients to see how much time is spent on forms, answering repetitive questions, and the like to reduce time between examinations. According to the paper, one California imaging center claimed a $200,000 annual yield after cutting time between examinations from 37 to 31 minutes, creating time for two more examinations per day.

Patient payment also can be streamlined for improved efficiency. By posting a payment policy in the reception area, training staff to review all payment options with patients, collecting the amount due before the examination, and educating patients in the benefits of credit programs, imaging centers can improve throughput and increase business.

The white paper is available as a PDF download at www.gehealthcare.com/usen/solutions/oic/docs/Blueprint.pdf.

Cat Vasko is associate editor of  Axis Imaging News.

MGMA Releases New Policy on Pricing Transparency

As digital mammography sweeps across the country, Digi-Solve LLC, Ponte Vedra Beach, Fla, has introduced an outsourced digitizing service for mammography, as well as a fee-per-procedure program. Both services are intended to provide a cost-efficient method to ease the transition between analog and digital.

Digi-Solve President John DeBiase says that the price of mammo-specific digitizers has increased over the years. “On top of that, there’s the labor expense and something we think of as a ‘hassle expense.’ Think about feeding thousands of films all day long into a machine, and that’s all you do.”

The company’s outsourcing program allows a facility to ship its priors to Digi-Solve, where they will be digitized using equipment from VIDAR Systems Corp, Herndon, Va. The digitized images are then returned to the facility via a secure T3 Internet connection, with a turnaround time of 1 to 2 days.

The fee-per-procedure program, with prices starting at $37.50 per examination, makes digital mammography technology available to facilities currently lacking the funds to invest in their own equipment. “For people who want to go to full-field digital and don’t have the capital, we turn around and work out a package for them where we charge them per procedure,” DeBiase explains. “We install the equipment, they use it, and they pay per procedure.”

The equipment includes FFDM gantries or CR mammography readers, workstations, and computer-aided detection systems; users also are treated to prior examination digitization services, digital storage, service and software upgrades, and flexible upgrade options. In addition to eliminating the facility’s need to invest in equipment, the service also can drive additional reimbursements, partially offsetting the program’s cost.

DeBiase explains how these solutions can improve workflow: “A lot of departments load a multi-viewer. Then, the radiologist comes in and deals with the contrast difference between the multi-viewer and the workstation. After the cases on the multi-viewer are read, the radiologist has to stop reading while it is reloaded. With the shortage of radiologists reading today, that can create a problem. With our service, you eliminate the space constraints and limitations of the multi-viewer, so a radiologist can keep being productive.”

DeBiase estimates that outsourcing could save facilities 20% to 25% in comparison to in-house digitizing; he estimates that his pay-per-procedure program could save 25% compared with a center’s costs to purchase and operate the equipment.

—C. Vasko