What Patients Need: Interaction and Transparency at Metro Imaging

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In 2007, Metro Imaging, a radiology group with five outpatient imaging centers in St Louis, Missouri, launched a program in which patients could opt to receive their preliminary results following their exams, in as few as five to 10 minutes. Harley Hammerman, MD, CEO of Metro Imaging, says, “When patients come in, they are given cards with their names and the exams they are having, and they can check whether they want the preliminary results; 95% say they want them.” Harley HammermanThe program initially created some controversy among local referrers, some of whom felt that the provision of preliminary results in the imaging center usurped their roles. “I’ve talked to other radiology groups about this, and no one’s doing it yet—they’re afraid of push back from their referral base,” Hammerman says. “We got some, but once the physicians understood it better and got feedback from their patients, they decided it wasn’t a bad thing.” Most important, Hammerman says, the program enhances patient satisfaction. “We take this for granted now; it’s a way of life and an integral part of our service,” he says. “Close to 40% of our patients say they come here because we give preliminary results before they leave. It’s something that we think is very special that has definitely made a difference in terms of our business. It increased our volume significantly. Patients love it, and we see that every day.” Patient Interaction Hammerman notes that the program has permanently changed the way that Metro Imaging’s radiologists practice. To deliver results while the patient is still in the office, radiologists have to perform preliminary interpretations the moment that images are made available on the group’s shared worklist. “You have to look at every image in real time because the patient is waiting,” he says. “Most of us just go ahead and dictate the whole thing. It has really changed how we practice—for the better, I think.” If patients want to discuss their results, a radiologist is available to talk to them, providing the kind of patient interaction that many practices claim to be too busy to offer. “The technologist will give patients the results on cards, explain what they mean, and answer questions,” Hammerman explains, “but if patients still have more questions, the radiologists will talk to them. It’s certainly the minority of patients; we’ve found we don’t need to talk to everyone.” Hammerman notes that he will often volunteer to discuss complex results with the patient, and he still only interacts with four or five patients a day. “We don’t think we’re losing time,” Hammerman says. ‘This is actually making us more efficient. Our productivity hasn’t suffered at all.” The reaction from patients has been unequivocally positive, he adds. “It goes much better than you might think, even though we stress that the results are preliminary,” he says. “Patients are just grateful that someone is talking to them.” Cost Transparency A newer initiative aimed at improving patient satisfaction focuses on exam cost. “This came about because of the economic downturn,” Hammerman explains. “In order to continue affording health insurance, patients were going to high-deductible plans. There’s a big difference between what we charge for an MRI or CT exam and what hospitals charge. Back when patients had no deductibles, it didn’t really matter to them—but now, things are different.” To get the message out about the cost differential, Metro Imaging hired an ad agency to produce television spots that ran in local markets; a section of the group’s website is dedicated to cost comparisons between the group’s imaging centers and local hospitals. “What we get across is that patients do have a choice: They don’t have to go where their referring physicians tell them to go,” Hammerman explains. “We empower patients by letting them know that they can go where they want to go if it’s more cost effective for them.” In addition, Metro Imaging puts its money where its mouth is by offering patients information about their out-of-pocket costs for an exam before they schedule it. “We get patients all the time because they call us and we can tell them exactly what an exam will cost if they get it here,” Hammerman says. “Can you think of anything else that you’re expected to buy without knowing the cost? Hospitals can’t give them that information, but we can.” Looking forward, Hammerman anticipates being well positioned to work within new payment models for these very reasons. “I had a discussion with a hospital administrator here, and he believes that in an ACO model, imaging will be a cost center for them,” he notes. “His idea was to put all the imaging decisions on the referring physician, and that scenario, for us, would be great. Referrers will want to work with the low-cost provider.” Cat Vasko is editor of Medical Imaging Review and associate editor of Radiology Business Journal.