Creating a Common Language with Radiology Analytics

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 - Benjamin Strong, MD, Chief Medical Officer, Virtual Radiologic (vRad)
Benjamin W. Strong, MD (ABR, ABIM)

Radiology analytics is one key asset with which to preserve our specialty’s future, prevent commoditization and avoid being viewed as a cost center to be managed as opposed to an indispensable partner with an earned seat at the table.  

We create reams of data every day in our practices; however, operational data like turnaround times, study volumes, modality types and referring physician names are not meaningful for true quality measurement.  Transforming data into information and “actionable insight” requires harnessing its inherent intelligence.  That means “speaking the same language” across facilities and health systems.

Today, data normalization is a manual, tedious and oftentimes seemingly impossible exercise due to the variability in descriptions and nomenclature.  Without a common language and a standard against which to normalize we can neither create quality benchmarks with which to compare performance against relevant peer groups nor have evidence-based discussion to drive alignment with our key stakeholders: our radiologists, referring physicians, hospital administrators, and ultimately the patients we serve.

Unique Access and Scale

vRad reads over 7 million studies every year, creating an unprecedented amount of data related to imaging services and outcomes.  As the nation’s largest practice, we have an intimate understanding of the trends impacting radiology.  That means that we have and will continue to experience the same disruption as our clients: the new normal of lower reimbursements, working longer hours for less and operating in an environment with ill-defined requirements.   Given our scale and scope, our medical leadership realized that the myriad changes in healthcare would impact us faster and harder than other radiology groups; we could not wait for events to overtake our practice and began the process of creating a new operating plan for our future over two years ago by leveraging the value embedded in our vast clinical data warehouse.

In the absence of a robust standard for aggregating study attributes, we created our own: the vCoder, a patent-pending data normalization solution that assigns 23 unique attributes to every study.  The vCoder leverages the expertise of vRad’s clinicians made scalable by our practice’s software developers – a partnership that has already resulted in 14 patents.   The vCoder is “command central” for our operating plan, orchestrates study movement within our practice (getting the right images to the right physician at the right time), and provides the means to assess quality, value and performance analytics in preparation for the shift away from a fee-for-volume world.  With the vCoder we have been able to normalize over 25 million studies, speak the same language with all of our 2,000+ client facilities, and create clinically relevant metrics that compare against statistically significant national and peer metrics: the RPCSM (Radiology Patient Care) Indices. 

While we initially set out to harness our clinical data to make us more efficient in making informed decisions for the health of our practice, we quickly realized that the multi-year process we went through is the same one that will be required by consolidating radiology practices, hospitals and health systems.  By sharing lessons learned from our two-year head start, we hope to create a community of interest with our clients and the radiology community at large to help make better decisions for the health of the patients we collectively serve.  That’s why we unlocked and released the RPC Indices for free and unrestricted use at www.vrad.com in November 2013. 

Driving to the 3 A’s with Insight: Accountable, Aligned and Affordable

Radiology groups are under increasing pressure to align themselves more effectively with their referring physicians and hospital partners; becoming an indispensable partner is critical for long term success.  Our practice is now using analytics with our clients to show how communication and alignment gaps can be bridged with evidence as opposed to unsubstantiated hypotheses. 

In a real-world example, one of our radiology group clients was being asked questions by hospital administrators regarding the use of MRIs in the facilities they covered based on discussions with one of their larger payers.  While they were able to get MRI volume data from their RIS, they partnered with vRad to benchmark their modality volumes against their relevant peer group: their MRI volume was indeed