Governance, Mission, Growth

Enhance Workflow and Cash Flow
Lower Dose, Higher Quality
Straight to the Heart
Bidding for Business

Enhance Workflow and Cash Flow

When it comes to coding and billing, imaging practices are seeking out ways to be proactive and cost-efficient. For PC Inc, an Anchorage, Alaska-based radiology, pathology, and emergency medicine coding and billing company, the desire to help their clients take control of these essential tasks drove them to adopt the most robust billing software around.

“We had reached the limits of functionality in our old systems, and were looking for the best out there in Windows-based software,” said Laurie Brock, administrator at PC Inc. “We were looking for the ability for patients to be able to pay online, and we were looking for a system that would allow clients to access their own information and report information online. In today’s world, our clients are intensely interested in being proactive in their business. When they saw the possibilities with Zotec, they were thrilled.”

PC Inc recently joined a flurry of groups licensing the Zotec Electronic Billing Center (EBC) suite, which includes the EZ Med Portal and Decision Support tools. The software suite is the foundation of Zotec’s revenue-enhancing products, and is designed specifically to accomplish better patient care, enhance workflow management, eliminate unnecessary labor, track productivity, and get cash flowing back into the care center. The software is now in use in 45 states, representing more than 5,000 physicians.

The system involves user-friendly applications with tools that provide automated claims processing, proprietary claims editing systems, automated secondary claims processing and appeals, comprehensive carrier requirement databases, integrated imaging, extensive practice management features, and an online portal for accepting payments and insurance information. PC Inc enlisted the Zotec software suite to enhance their medical coding and billing practices and better serve their clients’ needs.

“We chose the Zotec system for a number of reasons related to productivity and effectiveness,” said Brock. “The software itself provides so much automation at your fingertips, and does it with a very attractive and simple interface that flows. We are fully expecting that it is going to streamline our workflow, particularly in the accounts receivable follow-up department. We can eliminate a lot of processes that were very time-consuming on our old system, and could see a potential reduction in staff and overhead as a result.”

Over the past 2 weeks, Zotec has also announced that Atlantic Medical Imaging in New Jersey and Yakima Valley Radiology, PC, out of Yakima, Wash, have licensed its practice management/ billing software suite. Company leaders contend the recent growth is due to a widespread need to help physicians collect outstanding funds more efficiently and affordably. PC Inc knows this need is increasingly important in the current economic climate.

“We know that physicians and radiologists have this top of mind, and we’re confident that with Zotec we can better serve our existing clients and garner new clients,” said Brock. “Imaging centers and other areas we serve desire this accessibility of reporting, and making a very positive step in their business. With this new software, we can help clients do that.”

—Amy Lillard

Lower Dose, Higher Quality

Community Imaging, an outpatient facility located in the western suburbs of Chicago, began its search for a CT scanner last January with a few key factors in mind.

“We wanted to purchase a system that would decrease patient dose, while maximizing image quality,” said Amy Wendt, regional manager of Community Imaging. “Being an outpatient facility, we also looked for a scanner that would give us longevity in value and the best technology in the area.”

After evaluating technologies in the marketplace, the center found its best match in the Definition AS 40 scanner from Siemens Healthcare, which installed the unit at the facility in October. Already, Community has experienced numerous benefits.

“Scan times have been greatly reduced,” said Wendt. “Less contrast is being utilized, which reduces patients’ risks associated with contrast. Dose is being modulated by using Siemens’ Care Dose to adapt to patients’ specific body habitus, thus reducing overall dose to all patients. Our CT reconstructions are much more accurate and extremely diagnostic, and can be reconstructed to submillimeter sizes.”

According to Siemens, its SOMATOM Definition AS is the world’s first adaptive CT scanner. It can adapt to virtually any patient, in terms of dose protection, new dimensions, and space. Through the Adaptive 4D Spiral mode of the scanner, it addresses functional imaging of whole organs, allowing Siemens to offer dynamic information of up to 27 cm.

“Siemens is constantly focused on improving diagnostic quality while reducing dose in computed tomography,” said Peter Kingma, vice president, CT division, Siemens Medical Solutions USA. “With our SOMATOM product family, we continuously develop new ideas and solutions for maintaining ALARA guidelines to achieve success and to integrate these developments into our systems for dose reduction and improvement in patient safety.”

Prior to installation of the Definition AS 40, Community had a single slice scanner that required longer time slots on the center’s schedule—” actually double what they are now,” Wendt said. Scan times were challenging for patients, particularly for those who required a breath hold, she continued. Because the center had limited CT capabilities, staffers sometimes had to turn patients away. Furthermore, Community ran into communication issues, as the old scanner was not equipped with a modality worklist that could be integrated into the facility’s RIS.

Wendt said that despite some minor hiccups—the noise factor of construction, which interfered with radiologists’ ability to dictate noise free—the process of installation between the center’s contractors and Siemens’ project manager went very well. Two technologists traveled to Siemens’ North Carolina training center to receive three and a half days of training, complete with hands-on simulation. Furthermore, a Siemens applications specialist was available on site for the initial week of operation. The facility was down for 9 days, as part of the installation.

With the installation complete and imaging exams under way, Community now rests its eyes on the technology’s future applications.

“We plan to expand our line of CT offerings to include virtual colonography and lung screenings,” Wendt said. “We are also able to provide testing that we were previously unable to do, due to lack of technology, such as emergent PE exams, abdominal angiography, arterial run-offs, and contrast-enhanced angiography. Because of the dose reduction, we plan to target oncology practices to offer those patients who have repeat CT exams high quality with less radiation.”

—Elaine Sanchez

Straight to the Heart

California’s Salinas Valley Memorial Healthcare System is taking a multimodality approach to cardiac disease diagnosis and treatment with a full suite of imaging equipment from Toshiba America Medical Systems Inc.

The Cardiovascular Diagnostic Center, located at the Ryan Ranch Outpatient Facility in Monterey County, will use the Toshiba Aquilion ONE CT system and the Vantage Atlas MR system to perform advanced cardiac CT imaging and contrast-free MR imaging.

In addition, Timothy Albert, MD, the center’s director and an assistant consulting professor of medicine at Duke University, is using Toshiba’s Aplio Artida ultrasound system at his professional practice to evaluate his cardiac patients. The ultrasound uses 4D imaging and 3D wall motion tracking to create detailed images in the evaluation of heart muscle and valve function.

“Using a combination of the latest CT, MR, and ultrasound technologies allows us to offer the most effective and safest patient care to the community,” explained Albert. “When a patient is displaying a specific set of symptoms, we are capable of imaging them right away on the most appropriate system. That way, we can reduce both the contrast and radiation dose a patient receives.”

The Aquilion ONE utilizes 320 ultrahigh resolution detector rows to image the heart in a single gantry rotation. It produces a 4D clinical video showing up to 16 cm of anatomical coverage, enough to capture the entire heart and show movement such as blood flow.

“CT is the gold standard for coronary imaging because of the high image resolution and fast acquisition time,” Albert said. “The rapid, efficient cardiac imaging and the lower radiation dose of the Aquilion ONE were a perfect fit for the new cardiovascular center. It lowers radiation dosage by up to 80%, making CT imaging safer for patients.”

The Vantage Atlas MR system will be used to diagnose cardiovascular disease along with Toshiba’s proprietary contrast-free MR methods to improve patient safety. MR shows both anatomy and function, and is used in analyzing valve structure and heart function. MR also offers an imaging alternative without any radiation.

“MR has revolutionized the way we look at the heart,” Albert said. “New MR technology creates movie-quality images of the heart, which is like the difference between old black-andwhite television versus today’s highdefinition television.”

Toshiba’s contrast-free MR techniques include Fresh Blood Imaging (FBI), Contrast-free Improved Angiography (CIA), Time-Spatial Labeling Inversion Pulse (Time-SLIP), and Time and Space Angiography (TSA). Contrast-free protocols are particularly important in imaging vascular disease and patients with kidney dysfunction.

“The work being done by Dr Albert and Salinas Valley Memorial Healthcare System will change the way physicians use the full suite of Toshiba systems, including CT, MR, and ultrasound to diagnose cardiovascular disease,” said Girish Hagan, Toshiba’s vice president of marketing. “Across the board, Toshiba’s advanced technology is making medical imaging safer for patients by dramatically reducing radiation and eliminating contrast agents in certain procedures.”

—Verina Palmer Martin

Bidding for Business

Houston radiologist Daniel Roubein, MD, has launched a revolutionary online auction to offer medical imaging interpretations at a competitive price.

Daniel Roubein, MD

Roubein, CEO of Radiology Reading Centers of America, is building on the online radiology reading room concept with the Telerays network. This competitive bidding process removes the middleman and makes it easier for hospitals and imaging centers to tap into highly skilled doctors at fair prices. The service is available 24/7 and eliminates duplication because all reports are final. There are no exclusivity requirements, so radiologists can earn extra income or build their practices online.

When teleradiology was first introduced years ago, radiologists and imaging centers were wary of the practice. Today, it plays an important role in the medical imaging industry by allowing radiology facilities to provide services 24/7 while increasing efficiency and lowering costs.

“Change is always difficult, but new ideas are the future of any industry. Telerays is a revolutionary idea because it is a great equalizer. All parties are put on a level playing field and gain from the process,” said Roubein. “The same parameters that currently govern the practice of medicine and teleradiology apply to the Telerays model. We are committed to the care of the patient. The ultimate goal remains the same.”

Clients post their requests for interpretations on the Telerays Web site and prequalified radiologists receive an e-mail to bid on the contract. The lowest bidder wins the contract, downloads the cases, and uploads the final radiology reports. Roubein said Telerays’ processes are HIPAA compliant and protect private health information. Contracted radiologists are fully credentialed, and the radiologists supply only final reports.

The concept allows radiologists to work with their existing practice and earn additional income or build their own practice. Roubein said small hospital or imaging centers have direct access to quality doctors and larger facilities have access to more competitive pricing. In addition, radiologists can choose their cases, control when they work, and decide how much money they want to make.

“They gain a better lifestyle, as they are in charge of their time and their fees,” he said. “This is a fantastic time to be a radiologist. The field is growing, and the technological advances are coming at a phenomenal rate. There are new opportunities to embrace, which will improve the process and result in better care of patients and better lifestyles for doctors.”

California radiologist Bill Glenn, MD, the statewide medical director for Key Health Management, said he is eager to join Telerays. As a specialist in musculoskeletal imaging and an affiliate of the American Society of Neuroradiology, he hopes to compete by offering his expertise and rapid turnaround at modest prices.

“I’ve learned how to be lean and mean and fast. I hope that will appeal to some of the people out there,” he said. “I thought it was a very clever approach to put people with niche talent together with the places that need it, via the Internet. The economics of California radiology is to squeeze a little bit more, squeeze a little bit more. It’s tough. I need to find some extra revenues.”

Glenn said he admires Roubein for taking this new approach to teleradiology, and he’s optimistic about its success.

“He’s going to distinguish himself in the Internet imaging business community because he’s doing something different,” Glenn added. “I’m looking forward to seeing where I might fit in.”

—V.P. Martin