CXOFiles No.3 Marcia Flaherty: Vetting Business Opportunities at Riverside Radiology

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Many business opportunities for radiology groups become mired in an inability to act in the private practice sector. In order to explore the dynamics that facilitate entrepreneurial action within radiology practices, identified a practice that has successfully developed several new service lines in the past five years: Riverside Radiology Associates in Columbus, Ohio, a soon-to-be 60-radiologist practice, officially founded in 1980, but with roots that go back many years. Not only does RRA operate a successful full-service outpatient imaging center and interventional office, it has developed an information technology service and a brand-new teleradiology business, and also provides billing for some clients. We explored the process by which RRA assesses new business opportunities with Marcia Flaherty, who has served as practice CEO for seven years. Tell us about some of the most successful new service lines and delivery models RRA has developed over the past five years? 

FLAHERTY: Key areas have been Premier Medical Imaging, a multimodality outpatient imaging center with interventional services; COPS, our technology company; and, currently we are starting up our own internal nighthawk service. COPS stands for Central Ohio PAC System. It’s a technology company. We provide PACS services for a number of physician practices and hospitals. We utilize the Fuji Synapse system, and we also have a voice recognition system, Power Scribe. That technology infrastructure allows us to provide these services. We started providing services to a hospital that did not have PACS and were able to convert them into our system and changed their turnaround from days to literally hours. Everything now is done within 24 hours or less. We are able to create a very efficient environment. We also provide PACS for a number of the physician practices where we read studies, and an example is a large orthopedic practice that has a couple of magnets and CR. They needed a PACS product to support their imaging services, so we, on a per-click basis, lease them out PACS and store their images. Before we get into the method of vetting new opportunities, would you provide some background on how the group is governed? 
FLAHERTY: Our Board of Directors is comprised of all shareholders and those on a partnership path. New physicians immediately become members of the Board and are involved in the discussions of the group. Our Executive Committee (EC) is comprised of seven physicians, who represent specific areas of subspecialization, as well as our officers. We have four committees that report to the EC, and we try to get each Board member on at least one committee. These include the Operations Committee, which focuses on scheduling, recruitment, and information technology; the Finance Committee, which reviews financial details and oversees our billing company and managed care initiatives; the Professional Relations Committee—this committee along with the EC are elected committees—that deals with areas of professionalism and work-life issues, setting the standard for professional behavior and dealing with flexible scheduling models and reduced partnership options; and, the Business Development Committee, which reviews all business opportunities and in-depth business plans. Each committee makes recommendations to the EC, and the EC reviews and acts on the committees’ recommendations, then moves appropriate items on to the board for review and action. How are new opportunities presented to the group?
FLAHERTY: As described above, the Business Development Committee conducts due diligence on all new opportunities and makes recommendations to the EC for their review, and then each opportunity is passed onto the Board of Directors for review and action. There is a lot of work involved in the process. We go through a fairly extensive review process for opportunities. Most due diligence is done by internal resources. We have four key areas in our management: we have our technology, which is a huge area, we have a business development area, which includes our marketing and sales, we have an executive director of business development, and we also have a manager of operations. So that group is very much involved. They also developed our billing operation for some of our imaging pieces, so that group is very involved in new business development and bringing it on board. Then we have our clinical operations,