Business 101: Communication and Information Sharing in Radiology

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This article is the final installment in a four-part series on applying basic business concepts to radiology. To read the first installment, click here; to read the second, click here; to read the third, click here. Greg ThomsonDan Simile JrTo avoid succumbing to the tyranny of the majority in making business decisions, Dan Simile Jr and Greg Thomson of Medical Management Professionals, Inc (MMP), Atlanta, Georgia, recommend that radiology groups establish annual wildly important goals (WIGs) and make meeting those goals a practice-wide priority. Equally important, however, are the communication and information sharing that not only enable leaders and staff to track the execution of these goals, but also help them achieve the goals in the most efficient and informed manner possible. “Radiology’s environment is changing quickly and rapidly, from day to day,” Simile notes. “If you are not able to communicate quickly and effectively—to mobilize your organization to make good, solid decisions quickly—you can miss important opportunities.” Thomson adds, “It can take a month for some groups to get stakeholders in the same room. Decision making needs to be more efficient and effective, and the changing marketplace makes this more important than ever.” Decision Makers and Communication When Thomson and Simile allude to the tyranny of the majority, they are referring to the oft-noted commitment to democracy that can be the demise of radiology groups—especially large groups with many partners, each of whom might expect or receive an equal vote. To overcome this obstacle, especially as practices continue to grow in size, they recommend establishing a smaller group within the partnership to entrust with making on-the-fly business decisions. “You cannot have a democracy of 40 radiologists,” Thomson notes. “You need smaller decision-making groups.” Once a decision-making cohort within the larger partnership is established, however, rapid and effective communication to the rest of the practice becomes even more critical. “Typically, even if decision making occurs in a small group, ownership is still shared among a much larger group,” Thomson says. “Good communication with its members is extremely important—after all, it is often their livelihood that is at stake.” Simile adds that decision makers within radiology groups should take their cues from what might be the most dangerous competition facing the traditional practice: predatory, for-profit entities. “If you are being threatened by a corporate entity, if they need to meet, they will all stop what they are doing for a conference call or a Web meeting,” he says. “They will be in hotel rooms, at the airport, wherever, having that meeting to make a decision as soon as they can. Physicians have a certain mindset; it is hard enough to get them to stop working and think about the business side, much less to disseminate information and make decisions.” What to Share What groups should share with their members depends on both the members’ roles and the group’s overall governance; however, scoreboarding is critical to the achievement of WIGs because it allows every staff member to chart, visually, the progress that his or her department is making toward the overall goal. “Visibility is important to keeping the goal front of mind,” Thomson notes. “Everyone should see the scoreboards on a regular basis, whether they are in a central, physical location or posted on an intranet site where they are available to everyone.” Simile observes that groups should also share information that tracks their daily progress, including practice measures that relate to revenue and volume. “You need to understand where your volume is coming from and whether it is going up or down; in terms of measures to share, you want to choose the ones that are most relevant to tracking the performance of your practice—volume per day per site, amount of money deposited in your bank account each day, any payor-mix shifts, and so on,” he says. Thomson adds, “We often find that physicians have no idea what their practices’ daily deposits are; it is not something that is shared with them in any way. It helps, in terms of performance, when the people doing the work know it is being monitored by the leaders of their practice—it affects their motivation.” Communication in the 21st Century For these reasons, Thomson and Simile are advocates of using a next-generation approach to communication and information sharing that leverages today’s technology. MMP is in the process of developing a proprietary informatics tool that acts like a more robust version of a company wide intranet for this purpose; practices might also develop their own internal systems for the same purpose. “We are to the point where a group has information, its partners have information, but we have all these walls around the information,” Simile notes. “With the explosion of technology, we have so much information one person can theoretically control, but not everyone has the opportunity—or understands how to share what he or she has.” By using an electronic communication platform, practices can access a wide range of functions. Thomson and Simile offer as examples a document repository where practices can share information like hospital contracts or bylaws for easy access by staff, or an online polling system that allows partners to vote quickly on any potential changes to the business. Agendas for meetings can be shared, allowing staff to add items or prepare in advance for items that pertain to them; reminders can be sent to partners on target action items. “In an effort to be an effective and efficient decision-making entity, you first have to deal with those issues or topics that tend to take a lot of time,” Thomson says. “Talking about what your policy is on something should not be an hour-long exercise.” In conclusion, Simile stresses that times have changed for radiology, and communication and information-sharing processes need to evolve with the marketplace. “The speed of communication has changed, and what we will be seeing now is a need to consolidate the way it occurs,” he says. “Practices need to recognize that challenge and move toward ways to communicate more effectively.” Thomson adds, “Effective information sharing simplifies running the practice, so everyone can focus on what is truly important to the business.” Cat Vasko is editor of and associate editor of Radiology Business Journal.