Subspecialty Radiology in a Rural Setting: Winn Parish Medical Center

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Bryan BogleWinn Parish Medical Center (WPMC) in Winnfield, Louisiana, is like many community hospitals of its size, providing local patients with a broad array of services (ranging from a 24/7 emergency department and general surgery to more specialized services, such as occupational therapy, sports medicine, and cardiac rehabilitation). By mid-2010, though, the 60-bed hospital found itself struggling with one area in particular: its radiology services, which were provided by a small local group of three or four physicians until nine months ago.

Bryan Bogle, CEO of WPMC, explains that the community hospital was in a situation similar to that of many of its peers: Its service offerings had outstripped its radiology capabilities. “There’s no way a 60-bed hospital located in rural Louisiana can access a pediatric neuroradiologist, to use one example,” he says. “The local group was limited in the clinical offerings it could provide.”

In September 2010, WPMC contracted for its radiology services with Baton Rouge Radiology Group (BRRG) in Louisiana, a practice of 25 board-certified radiologists with a range of subspecialty credentials. BRRG handles the hospital’s radiology needs by day, and it partners with Virtual Radiologic (vRad), Eden Prairie, Minnesota, for night and weekend interpretations.

Bobby Strong, radiology director at WPMC, says, “Radiologists are moving to bigger cities, where physicians are joining together in bigger groups. Working with BRRG was what we had to do to make sure we had the radiology expertise we needed.” Bogle adds, “From the clinical perspective, it was a no-brainer.”

Technological Connection

Bogle explains that today’s RIS, PACS, and telecommunications technology enabled WPMC to make the switch to coverage from BRRG painlessly and seamlessly—in spite of the fact that the radiology group is based in Baton Rouge, which is more than 160 miles from Winnfield. “We have no on-site radiologist now,” Bogle explains. “Everything is done by PACS, and BRRG has the infrastructure established to funnel our studies through to vRad by PACS as well. It makes the access to care for us just incredible.”

The hospital’s imaging modalities include CT, MRI, ultrasound, and radiography, all of which transmit studies to the right radiologists—to BRRG or (after hours and on weekends) to vRad. Strong says that turnaround time has significantly improved. “Before, turnaround time had a lot to do with whether the physician was actually at his or her desk,” he says. “There’d be good turnaround during work hours, but after hours or during the radiologist's lunch breaks, you’d see it really slow down; we’ve improved our turnaround times dramatically since working with BRRG.”

That’s no small accomplishment, since the hospital’s primary business on nights and weekends comes through the emergency department, Bogle says. “On the weekend, anything we need will generally be for folks coming through the emergency department, and in that kind of setting, time is obviously of the essence,” he notes. Strong adds, “What emergency-department physicians want most from radiology is for their cases to be read quickly. Right now, they’re very satisfied with the service they’re getting.”

Growth Potential

WPMC currently provides many of its subspecialty services through special arrangements with larger hospitals outside its immediate service area. Physicians such as orthopedic surgeons, cardiologists, neurologists, and gastroenterologists contribute half a day every week or every other week, enabling WPMC to maintain patients’ access to advanced clinical programs. “We’re an hour from the nearest facility that provides a broader array of services,” Bogle says. “We’re trying to keep people closer to home.”

Thanks to its relationship with BRRG and vRad, the hospital is one step closer to accomplishing that goal: Being able to access a wide range of subspecialty radiologists has allowed the facility to consider adding new service lines that were out of its reach in the past. “There is a way to grow the department, even with the radiology group off campus,” Strong says.

Bogle cites interventional radiology, new surgical programs, orthopedics, and neurology as service lines that the hospital is considering adding to its mix. “It will take some equipment acquisitions, of course, so we have to determine how much business there is for these areas and whether we can capture it,” he says. “We want to start providing more and more services to