Building Radiology’s Relevance: Greater Houston Radiology Associates
As a neuroradiologist, Ray Kirk, MD, president of Greater Houston Radiology Associates (GHRA) in Texas, often considers both the financial and clinical futures of the specialty. “Where radiology is today,” he says, “there is a need to make ourselves more relevant to the patient-care process in the eyes of our customers—hospitals, referring physicians, and patients. If we cannot do that, I think we are seriously at risk. We must reinforce that we are consultants to avoid becoming a commodity.” Combined with the ongoing imperative to be more productive for less reimbursement, the need to enhance patient care creates a quandary for radiology practices that Kirk believes can be solved through proper use of the data residing in their information systems. “The more our practice learns about itself, the more we realize the potential of using business intelligence,” he says. “It’s getting us valuable data that allow us to assess what we are doing and make decisions more quickly and efficiently, with a higher level of quality.” The goal of improving patient service might seem to be at odds with the goal of making the most of limited reimbursement, but Kirk believes that in the payment and delivery models of the future, these two objectives will dovetail in a way that will make the use of business intelligence critical for the survival of radiology practices. “Informatics and analytics are very beneficial, but seem very black and white,” he notes. “They are helping us in a very perilous time, but more important, they enable us to be more directly relevant to our customers’ success.” Distributing Services GHRA is a 10-radiologist practice that reads studies for two community hospitals, as well as an array of outpatient facilities and clinics. Increasingly, Kirk says, the practice’s radiologists do off-site work, reflecting their deepening subspecialization. “A lot of contract work comes to us from facilities we are not staffing on site,” he says. “It’s very disparate. We want to take all these different sources of information and make them compatible so we can read—across our practice—from a unified worklist, and so we can increase quality and efficiency (and provide a more refined product for our customers).” To meet this need, GHRA turned to its provider of revenue-cycle management, Integrated Medical Partners, which offers a solution for distributing imaging services and draws business-intelligence data from it. “The concept of distributed radiology is one I have believed in for a long time,” Kirk notes. “There is a lot that can be done with that in terms of using the data to provide feedback, and that’s what we are looking for the most—actionable data, for ourselves and our customers, to provide a better, more efficient product and to increase our per-case reimbursement.” Kirk sees this capability as particularly critical in light of both recent and imminent changes to health-care delivery. “As reimbursement goes down, we can use analytics to prove a competitive and quality advantage, but that is only the first step,” he says. “Having the ability to provide informatics to our partner organizations as well will enhance that advantage. As models change and we get into accountable care and bundled services, we can then be in a position to command a higher level of reimbursement.” He adds, “Building better customer relationships and creating a more secure organization, coupled with distributed workflow, enables us to create our own benchmarks and scorecards and provide better incentives.” Uncertain Future With the future of health care (in general) and radiology (in particular) so difficult to predict, Kirk anticipates taking advantage of business intelligence even more, in the years ahead, to keep his practice competitive and agile. “You try to decide what the best business is to retain or develop further,” he says. “You also provide the constant use of data and informatics as a feedback tool. In the future, radiology is going to have to make and prove its own case. Increasingly, radiology’s customers will expect more of a managerial role and leadership on radiological issues, including utilization management.” For instance, he says, in constructs such as accountable-care organizations, there is a risk of radiology being treated as a marginalized commodity—but making full use of data can change that. “If you can provide actionable data to your customers and make yourself directly relevant to their success, you’re not a commodity or a vendor,” he says. “You are a true business partner, adding value to them and using that in conjunction with a direct interest in satisfying their customers, and that will ensure their success in the future.” Personal interaction with physicians and patients will be just as important as delivering useful analytics, Kirk predicts, and for that reason, he is focused on moving toward a regional business model that would leverage the economies of scale of distributed imaging without sacrificing consultative service. “The distributive component allows us to provide subspecialty service at the level our customers need, but subspecialty service also means coming out from behind our distributed system and interacting with that patient and the family,” he says. “How to do the best of both is a big question.” Here again, the practice’s data will come into play in positioning it for the future. “We’ll match our capacity and skills to utilization and the business that is out there, and we’ll develop projection models so we can take it further into the future,” Kirk says. “It’s a high-wire act that will be aided by informatics.” Cat Vasko is editor of RadAnalytics and associate editor of Radiology Business Journal.