Nine years ago, when radiologist Kevin Barker, MD, joined the solo practice of Dr. Anson Cone, Community Radiology Associates (CRA) covered one imaging center and one rural hospital, and enjoyed high regard from referring physicians in the Texas Hill Country, a vast, 25-county region marked by rugged hills separating Austin from San Antonio.
Today, the practice employs 13 radiologists for a total of 15 and covers 70-plus sites, including rural hospitals, imaging centers and physician offices, interpreting close to 300,000 images annually. It is a success story that came to be thanks to choosing just the right web-enabled PACS for CRA’s needs.
“In the past, where you sat is what you read,” Barker says. “Your income/revenue stream was based solely on how busy the site was where you were working. Now, we as a group would be handcuffing ourselves if we still worked off of that model. To maximize efficiency, productivity and thus income, a radiologist/group MUST have the ability to move studies from one site to another and from one radiologist to another in an attempt to place the appropriate type and number of studies in the hands of the most qualified and capable radiologist.”
As Barker explains, two years into the partnership, the radiologists acquired what he called a pseudo-PACS so that they could read stat images from home in the middle of the night. They soon tired of the slow download times and upgraded to a better system. By the time they had grown to between approximately 20 sites, including four rural hospitals, they knew they needed a more robust solution and again went shopping.
“About five years ago, I looked at multiple different PACS, and Viztek was the perfect solution for my practice,” Barker says. “I could buy my server, house it where I chose, and with the web-based platform, my partner and I, wherever we were, could divide and sort the studies between the two of us so that we could optimize workflow and report turnaround times. For instance, I would put four or five sites on my "to be read" list and he would do the same on his, and we were very quickly able construct not only our workflow but also out entire workday in the most efficient way possible.”
Prior to implementing Viztek’s Opal-RAD, Barker spent at least an hour each day logging onto a multitude of different hospital or doctor’s office PACS, reading a handful of studies from each site, and logging off only to log back on to the next site's PACS, over and over, all day long.
“When I went to Viztek, my productivity improved 40 to 50 percent just by reading all of my sites studies on one PACS,” he recalls. “I went from being super busy every day to where I was done by 1 o’clock in the afternoon. I then realized, ‘We’ve got to find more sites! There is so much more I can do in a day with this new PACS platform.’”
A growth path
With time on their hands, the partners hired a Business Development Director Michael Cox. “He started pounding the pavement and spreading the word, and we picked up more hospitals, more imaging centers and more doctor’s offices,” Barker says. “Today, we have 70-plus sites, all across Texas.”
CRA’s clients are diverse, ranging from a 110-bed hospital down to a doctor’s office that sends three x-rays a day. “We are a perfect hybrid,” Barker says of the business model. “We have 15 radiologists, some full time, some part time, but we have eight different radiologists working on any given day, in locations around Austin and San Antonio. Those eight FTEs are not reading only the hospital where they are located, but we are shipping in via teleradiology from hospitals and sites all over the state to each radiologist.”
Almost all sites—with the exception of the large hospital clients—are read off of the Opal-RAD PACS, providing efficiency previously not enjoyed. At 5 p.m., the night shift comes on, and all studies are sent to Viztek and consolidated on one worklist. “Evenings and weekends, each radiologist reads from home,” Barker says. “All have the same workstation at home that is onsite at the hospitals.”
Throughout the five years that CRA has had the Viztek PACS, the practice has grown along with the solution, Barker says. “Viztek has made it very efficient over the years by listening to what radiologists want,” he explains. For instance, Barker, a diagnostic radiologist, as well as all other group members, have the ability to customize their toolset.
Consolidating onto one worklist turned out to be the growth engine the practice
Cheryl Proval is the editor of Radiology Business Journal and VP, publishing, ImagingBiz.