Leveraging IT for Better Service

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Don Trexler, CEO of Baton Rouge Radiology Group (BRRG) in Louisiana, wants his practice to be different from a typical imaging group. “We’re a full-service radiology firm,” he says. “The radiology market, in general, is becoming more and more price conscious. To be in a leadership position when it comes to contract negotiations, we have to make it about more than cost; it also has to be about service, while keeping our patient care and quality the top priorities.”

imageDon Trexler, CEO

BRRG has certainly fulfilled that objective. The 25-radiologist group, which owns and operates two imaging centers, also provides subspecialty imaging services for 10 hospital clients via teleradiology, and it brings the functions of an “extensive billing and IT operation,” in Trexler’s words, to all of its clients. “We’re a management firm,” he says. “Not only do we bill and collect for our physicians, but we’ll provide IT services to our teleradiology hospitals, and marketing and pro formas for our rural hospitals. We’ll do equipment assessments and quality assurance (QA) for our facilities, peer-review work, ACR® accreditation services, and more.”

BRRG employs close to 100 FTEs to fulfill its service objectives. “We’ve developed expertise in all these areas in-house, so we can turn around and say, ‘We’ve already done this; we can support you,’” Trexler says. “The bigger hospitals are pushing us for the best of the best in service, so we’ve spent a lot of time developing QA programs and interventional programs, and doing equipment analysis for the higher-end hospitals. It’s one thing to be a good radiologist; it’s another to be a good radiology firm. BRRG is both.”

Improving Workload Distribution

In keeping with the aim of improving service, two years ago, Trexler and his team began the process of reevaluating BRRG’s workload-distribution processes. The system that BRRG had in place, at the time, involved one of two routes: either hospitals pushed images to BRRG to be read from the radiology group’s PACS, or BRRG radiologists accessed the hospitals’ disparate PACS platforms to perform interpretations. “If you’ve ever seen radiologists work when they’re on call, they’re rolling from workstation to workstation while the fax machine is spitting out requisitions at light speed,” Trexler says. “We realized this was an inefficient model, so we went shopping for a system that could integrate with all of the outside PACS, hospital information system, and RIS platforms. Our ultimate goal was for our physicians to read off one system.”

The benefits to the centralized distribution capability BRRG sought were myriad, Trexler explains, especially because the practice does have a subspecialty focus. “We wanted to be able to move images to the most appropriate provider as fast as possible,” he says. “If I have an MRI of the knee that needs to be read, out of the 17 physicians working today, I should be able to send it directly to the worklist of a musculoskeletal subspecialist who is available to provide the service as rapidly as possible.”

Trexler and his colleagues chose the Synapse® platform for RIS and PACS from FUJIFILM Medical Systems USA (Stamford, Connecticut), which enables the practice’s radiologists to read more efficiently. “What the FUJIFILM system allows us to do is input the study into the system and, first of all, be able to see whether we’ve seen that patient before. The system will fetch any prior studies so we can do a comparative interpretation, and it will move the images to the most appropriate radiologist working that day.” The Synapse RIS will also be able to identify who is credentialed, in which subspecialty areas, at which BRRG reading locations.

“If you’re covering 70 client sites and 10 hospitals, all with different PACS, a new physician has to learn potentially 5 to 10 systems,” Trexler says. “It’s a complex work environment with a high learning curve. By working off one system, you reduce your complexity, you improve your access, and (we hope) you’re improving quality of care.”

The Service Angle

The ultimate aim of BRRG’s recent revamping of its IT infrastructure is to improve service—a particularly important goal for a radiology company facing challenges felt by groups nationwide, including declining reimbursement and an increasingly competitive marketplace. “We believe the competitive nature of radiology is continuing to increase, and radiologists’ being employed by hospitals or corporations is the easy