Pat Kroken began her session this morning by referring to herself as “the ultimate capitalist.” She mentioned a few operational issues that can be overlooked by radiology groups working with hospitals, including the issue of remote reads touched on by Dr. Borgstede. “Remote reads introduce a whole new business dynamic to the hospital-radiologist relationship,” she said.
Hospitals, she said, determine quality in radiology based on several factors, some of which might seem petty or insignificant to radiologists:
--Reports dictated quickly and results are called for significant findings
--Radiologists sign reports promptly and don’t have to be reminded
--Consistent participation in the Q/A overread program
--Techs are treated courteously
--Cooperation in technology initiatives
--Participation on hospital and medical staff committees
--Adherence with “administrative” provisions of professional services agreement
Kroken mentioned a group who brought in a teleradiology group on a provisional basis. At first, hospital medical staff were reluctant, but before long they were won over by the fast response, the subspecialization, the ease of access to reports and the service. “If you’re not paying attention to these things, you’re up against some major hurdles,” she cautioned. “In the old days, exclusive contracts offered some illusion of protection. There was a certain amount of room, then, for bad behavior, like abuse to technologists, or blowing off the administrative things. Over the past four years, things have changed. Now hospital administrators are not afraid to pull the trigger.”
She says hospitals look at quality in terms of cooperation and participation, not in terms of where radiologists went to school. Furthermore, they may even require certain subspecializations, like pediatric. “These are things that are very doable, but we need to take them seriously,” she said.
Before you outsource any coverage, Kroken recommends that you make sure your current service levels can compete with the remote company – and that you shore up your hospital relationship, establishing and nurturing a collaborative relationship. “You need to really have a good feel for what issues your hospital is facing,” she said. “Radiologists don’t talk often enough to the hospital administrators. You’ve got to break that barrier and establish mutual goals, not just come in with a list of demands.”