Health Imaging & IT – Integrating RIS/PACS for the Enterprise - (Page 9)

by l I s a F r at t Imaging Center battle strategies Combating DRA done in another area. IVs, for example, are started outside of the suite. The changes increase MRI capacity by 20 percent. The new MRI suite mimics the design of a CT staging area that lets the practice optimize time in the scanning room. Still, Marichal hopes to reduce CT exam time in 2008. The current model schedules three studies per hour with room for add-ins; Marichal expects to increase volume to four studies hourly. Centricity RIS-IC facilitates the approach by allowing the practice to customize times for various studies. CT runoffs, for example, are booked in 30-minute slots. Radiology and Imaging Specialists also added a third ultrasound system to eliminate a two-week ultrasound backlog and increase capacity by 50 percent. The investment meets a number of objectives, says Marichal, helping the practice eliminate the backlog, improve referring physician satisfaction and increase volume. The group anticipates a similar scenario next year when its PET lease expires. Currently, PET is marginally profitable due to the dramatic DRA payment reductions. “We’d like to pick up the volume, but the scanner is at capacity,” Marichal says. “We’ll have to determine if investing in an upgrade is merited.” Radiology and Imaging Specialists will run projections based on current reimbursement and payor mix, and use a very conservative growth factor to see what the ROI looks like. If the practice can add additional volume to offset the payment reduction, they can make an informed decision. But the additional investment may not be not warranted. “Every situation is different. The center has to find the tipping point [where revenue increases offset the acquisition costs and DRA-instigated losses] in each situation,” explains Marichal. Another factor in the complex calculus of DRA is staffing. Radiology and Imaging Specialists decreased clerical staff and technologists from a peak of 83 FTEs in March 2007 to 75 currently through attrition. Overtime was minimized or eliminated, and PRN staffing was dropped to reduce overall staffing costs. In addition, the practice cross-trained techs on multiple modalities, so they could better accommodate fluctuating volume across modalities. “There was some resistance,” admits Marichal, “but the practice chose to share the fiscal reality of DRA with staff, which helped secure buy-in.” Although the practice is increasing volume in multiple ways, it does not plan to add radiologists. Instead, it relies on sound workflow and tight RIS/PACS integration to achieve a distributed reading model. The final piece of the diversification puzzle is radiology informatics. Radiology and Imaging Specialists leases its RIS/PACS to an outside multi-specialty clinic and plans to offer the same service to a local trauma clinic in conjunction with professional xray services. The next step entails creating a new corporation to provide radiology informatics consulting services, such as HL7 interfaces, to other healthcare providers. “We have the IT backbone, infrastructure and intellectual capital to diversify revenue this way,” sums Marichal. DRA is the new reality for imaging centers. A robust practice management/data mining solution can help forward-thinking sites pinpoint spots with potential to recoup revenue losses and project gains with new endeavors. n Coping with the dramatic reductions in Medicare payments brought on by the Deficit Reduction Act of 2005 (DRA) has been a huge fiscal challenge for imaging centers and physician groups across the country. The best strategies are proactive and diverse. Take for example Radiology and Imaging Specialists (RIS) of Lakeland, Fla., a busy outpatient imaging practice that completes 150,000 exams annually. The four-facility practice started its DRA planning process early in 2006. The first step, says COO and CIO David Marichal, was to pull data from its GE Healthcare Centricity Group Management practice management system and project a worst case scenario. “Our projected revenue loss was significant; it reached into seven figures,” recalls Marichal. The solution centered on a simple question: what will it take to offset the difference? The practice realized it needed to diversify its revenue streams and decided to employ a multi-faceted approach. The natural first step for constrained imaging centers is to increase volume. Radiology and Imaging Specialists increased volume in several ways. First, the practice increased its two hospital contracts to four at the end of 2006. The combination of GE’s Group Management and Analyzer solutions helped the site pinpoint revenue decreases by modality and determine the amount of additional revenue to be gained with each hospital contract. The Analyzer system downloads data onto a separate server every night and provides heavy-duty data mining capabilities, allowing the practice to drill down into individual payors or specific procedures. The new contracts helped offset revenue drops, but did not comprise a complete solution. The practice also updated some modalities to offset revenue decline, including a 1.5 Tesla MRI scanner. It designed the new suite to better stage patients, recapture time and maximize the scanner. The primary principle in all exam areas is not to do anything in the room that can be HealthImaging.com Integrating RIS/PACS for the Enterprise http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Health Imaging & IT – Integrating RIS/PACS for the Enterprise

Health Imaging & IT – Integrating RIS/PACS for the Enterprise Table of Contents Integrated RIS/PACS: Making Work Flow Singular Benefits: Integrated RIS/PACS Delivers Imaging Center Battle Strategies: Combating DRA Spurring Reading Efficiency in a Large Imaging Center Group Creating the Global Imaging Record RIS/PACS for the Community Hospital What’s the Best? Single Vendor vs. Best of Breed

Health Imaging & IT – Integrating RIS/PACS for the Enterprise

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