5 actions steps for radiology to respond to the strategic shift of Hospital as Customer

This summer, I had the privilege of moderating an N-of-8® group during the AHRA conference for medical imaging in Dallas.

In the conference bulletin, Jim Sutton CRA, FAHRA published this viewpoint on the dramatic shift in the business environment between radiology practices and hospitals.

 "An increased number of radiology practices are being terminated from long- standing contractual relationships with their hospitals.

The evolution of teleradiology has changed the rules between radiology practices and hospitals. It has raised the bar for service expectations, such as rapid report turnaround times, the use of technology (e.g., physicians and ER can review images and reports), improved accessibility, and the availability of the radiologist for consults. And teleradiology companies specialize in high service levels. So unless your practice’s service levels meet or exceed those of the outsourced company, you may have introduced the hospital to a new level of service expectations and possibly your replacement. Thus, remote reads introduces a new business dynamic to the practice/hospital relationship.

There is also the quality of the hospital setting to consider.

For example, do your radiologists provide reports dictated promptly and results of significant findings? Are their reports signed promptly? Is there consistent participation in QA? In hospital settings, techs aren’t turned away, and there is cooperation in technology initiatives, such as voice recognition, and participation of hospital and medical staff committees.

For many radiology groups, hospital can represent more than 80% of revenue. So the hospital will roll the dice on its relationship with the practice. Remember, medical staff and community loyalty is not a lock. Hospitals expect quality in terms of service levels and participation. So the question is, if hospitals have shown they are willing to pull the trigger to end an agreement, is your radiology practice willing to risk playing hardball?

Radiology practices need to shift their view of the hospitals, and see them as customers. So how would a vendor treat its largest customer? Would the customer get special attention? Could the customer expect higher service levels? Would the vendor strive to partner with the customer for long-term success?

To save the relationship, group leaders need to recognize and lay out the reality of the relationship to the practice. They must review the professional service agreement (PSA) for areas that need to be addressed. Leaders must consider the hospital’s financial condition in terms of radiology. Where is it losing income/ cases? Are you asking for financial support from the hospital? Where does the group participate (or not)?

Make the first move.

The hospital is a valued customer. As in life, both sides must be committed to making a relationship work.

1.    Consider requesting a meeting with hospital administration and express your willingness to partner with them.

2.    Suggest a joint operating committee concept involving practice leadership, hospital administration, and departments like IT, medical records, and QA.

3.    Set goals and projects for the committee for items such as strategic planning, process improvement, communication, turnaround times, etc.

4.    Going forward, follow up on promises and projects, market to the hospital, and pay attention to details in your PSA.

5.    And definitely make sure your service levels surpass those of the telerad company!

To survive and thrive in the future, practices must learn to view life from the hospital’s perspective and move to a collaborative role/partnership with hospitals."