IMPROVING RADIOLOGIST PERFORMANCE - it's not about speed by Timothy Myers

Radiologists are the most expensive resource a radiology group possesses. Each radiologist must perform at their maximum efficiency in order to provide the greatest benefit to the group.  Radiologist compensation strategies, in order to remain in line with the new payment schemes need to be based on increased quality and efficiency, not just quantity.

There are a finite number of hours available in each day and inefficient radiologists cost their colleagues and partners time that could be used to make calls to clients, take extra time with patients, work with hospital administration or serve on committees. All of these nonreading/nonproductive tasks take away precious productive time but are required for radiology groups to maintain their leadership roles in radiology and imaging. Increasing efficiency is what buys the time needed to perform these additional tasks.

Simply reading faster is not the answer. The speed at which a radiologist reads is similar to how runners run. Each radiologist appears to have a reading “pace” that is set by many factors. If a runner does not run their typical pace, injuries or poor performance can result. With radiologists, going faster or slower than their built-in pace can result in greater inaccuracy and decreased quality.

The idea of simply reading faster rather than improving efficiency to try to increase a throughput of cases has also been studied and reported in a number of articles including an article from the Journal of the American College of Radiology (JACR). The article, The Effect of Faster Reporting Speed for Imaging Studies on the Number of Misses and Interpretation Errors: A Pilot Study. This article “found a significant positive correlation between faster reading speed and the number of major misses and interpretation errors.”

Our own review of quality assurance focused on radiologists with higher reading rates demonstrated that radiologists who simply increase their reading rate frequently decrease their accuracy.  This results in an increased rate of quality assurance discrepancies and the risk of higher level/more serious quality assurance discrepancies. This decrease in accuracy typically goes hand in hand with an increase in the rate of complaints by clients as the radiologist's report quality also deteriorates.

Increasing efficiency has nothing to do with increasing reading speed

Efficiency is not something taught in residency or fellowship; however, it can be taught. At the same time, improving efficiency, if taught and developed correctly has the added benefit of improved accuracy and quality.

Specific areas that need greater attention to improve efficiency, accuracy and quality include:

  • Voice recognition training to ensure maximum use and efficiency of voice recognition. Not just training the system but training the radiologist to use the system.
  • Developing personalized macros and templates for radiologists provides the structured and organized reports demanded by hospital administration, clinicians and patients who will very soon have direct access to our reports.
  • Group personalized templates and macros that can be used to improve billing with CPT codes and descriptions accompanying each report.
  • The ability to produce reports that can easily be data mined to generate information that will improve understanding of individual clinician and clinician group usage of imaging in general and specific types of imaging, hours and days of utilization. This type of data can then be used to target clinicians for improving utilization and providing more information regarding appropriateness and decision support.

Voice recognition

Voice recognition is often overlooked when trying to increase efficiency or throughput by a radiologist. Voice recognition and its various parts are the single most important tool that can be manipulated to improve efficiency.

Voice recognition can be used to great advantage by radiologists who understand it: its limitations as well as strengths. Voice training is typically looked at as something to be endured. Ensuring that the radiologist is training the system rather than the system training the radiologist is the first step.

 Next, developing macros (sentences or parts of the dictation) and occasionally templates (sentences or parts of a dictation with a fill in the blank area or areas) improves the ability to organize and structure reports. This allows a report to be generated as the study is read with a report being completed when the radiologist completes the review of the case. Using macros, which occurs with high repetition, improves voice recognition and significantly decreases voice recognition errors. The use of macros and templates also decreases the need for free dictation which has a moderately to significantly higher rate of voice recognition errors.

 Example of a macro:

ORBITS: The globes and intraorbital structures demonstrate NO acute changes.  The bony orbits demonstrate NO acute fractures.

 Example of a template:

VENOUS STRUCTURES: There is NO evidence of deep vein thrombosis from the common femoral to the [visualized calf veins].

 IMPRESSION:

1. NO evidence of deep vein thrombosis in the visualized venous segments as noted.

 NOTE: The “[visualized calf veins].” is the templated area. This area can be left as is or changed by selecting the region of the template and adding free text or a macro.

 Finally, macros can be used to place CPT coding information for accurate billing (see below).

 Case review

Using an organized approach to review cases ensures that all organs and structures are evaluated. This sounds simple but many times radiologists lose significant time by reviewing organs or areas of a radiograph repetitiously rather than reviewing each organ or area only once.

When eye movements are tracked, instead of relatively straight lines that are reproducible over a series of cases, disorganized reviews follow disorganized patterns or loops which are not reproducible between cases. This disorganized review pattern decreases efficiency and increases the time it takes to review any one element.

 Putting it all together

Using an organized approach to reviewing the examination and dictating using macros and templates as the case is reviewed provides a check-and-balance process. At the end of the case, each organ or system is represented within a clear and concise report. This ensures both the clinician and the radiologist that all areas of the examination were evaluated. Abnormalities can be highlighted in a number of ways to ensure the clinician identifies the critical areas within the report and the areas within the body of the report where more information about the abnormality can be found.

Example normal report:

CHEST X-RAY, FRONTAL AND LATERAL VIEWS.

CPT: 71020 . Chest x-ray, 2 view study , frontal and lateral.

 INDICATIONS: Chest pain.

 COMPARISON: NO relevant prior studies are currently available for comparison.

 FINDINGS:

HEART: The heart is normal in size and position.

LUNGS AND PLEURA: The lungs demonstrate NO consolidations or effusions.

MSK: The visualized skeletal structures demonstrate no acute changes.

 IMPRESSION:

1. There is NO evidence of acute abnormalities.

Example abnormal report with a critical value:

CHEST X-RAY, FRONTAL AND LATERAL VIEWS.

CPT: 71020 . Chest x-ray, 2 view study , frontal and lateral.

INDICATIONS: Chest pain.

COMPARISON: NO relevant prior studies are currently available for comparison.

FINDINGS:

HEART: The heart is normal in size and position.

LUNGS AND PLEURA: The lungs demonstrate NO consolidations or effusions.

CRITICAL FINDING: 25% pneumothorax in the RIGHT lung apex.

MSK: The visualized skeletal structures demonstrate no acute changes.

 IMPRESSION:

FINDING CONSIDERED CRITICAL TO PATIENT CARE:

1. 25% pneumothorax demonstrated in the RIGHT lung apex.

 Conclusion

Each radiologist must perform at their maximum efficiency in order to provide the greatest benefit to the group. Improving radiologist efficiency does not increase a radiologist’s reading speed but it does improve their throughput of cases with greater accuracy and quality. This increase in efficiency allows radiologist compensation strategies to be based on increased quality and efficiency, not just quantity.

This increase in efficiency has an immediate return on investment by decreasing the need for new radiologists as each radiologist becomes able to read more cases. As importantly, time is saved which can be used to improve clinician, hospital administration and patient satisfaction through increased involvement by individual radiologists and the group in general.


THE PATHWAY TO DOMINATING RADIOLOGY AND IMAGING by Timothy Myers

THE PATHWAY TO DOMINATING RADIOLOGY AND IMAGING

News | July 08, 2015 Practice ManagementTeleradiology

By Tim Myers, MD

Airpower and on the ground military power separately, cannot win a conflict. Together; however, the combination can be devastating. – Anonymous.

A report from Transparency Market Research recently stated that the global teleradiology market was worth approximately $0.92 billion in 2012.  The estimation is that this market will grow at a rate of approximately 22.3% between now and 2019, resulting in an estimated worth of approximately $3.78 billion in 2019. 

With this much money entering the market in such a short period of time, as stated in my previous columns, the pressure to dominate the market will be irresistible for corporate and imaging players alike; but who are the major players?  As the future of radiology will potentially be determined, or at least significantly impacted by what these groups do, radiologists should know who they are and their strengths and focus points.

The radiology/imaging market is difficult to parse and identify a specific percentage of market share.  Not only do you have to take into account size, but also growth, visibility, and the more ethereal quality of influence. Finally, you have account for the military dictum from above; airpower or on-site power alone cannot win. A win in this case would be a national radiology group.  This group will need a strong and/or dominating teleradiology system supporting and supported by a combination of local and regional on-site radiology partners who, in turn, dominate their markets.

My top picks for the four major players currently in the market include vRad/Mednax, Aris, Strategic Radiology (SR), and Imaging Advantage (IA). There are a number of mezzanine players and a myriad of small players also in the mix, but in my opinion, they do not have the numbers of radiologists, or the visibility or influence required to play at the national level.

- See more at: http://www.diagnosticimaging.com/practice-management/pathway-dominating-radiology-and-imaging#sthash.Wb1bCpa4.dpuf  

by Timothy Myers

RADIOLOGY MYOPIA: HOW YOUR RADIOLOGY GROUP'S VISION AFFECTS THE HOSPITAL'S BOTTOM LINE

Radiology groups don't want to hear that their failing practice is directly related to the state of their company's leadership; it is far easier to place the responsibility for a blundered imaging strategy on clinicians, administrators, and a series of ever-evolving changes—changes to the market, to health care, government regulations or shifts in reimbursement. Placing the blame on external factors is often a root cause of their failure, however. This is why Capstone leadership keeps it focus on solid, foundational imaging principles in order to deliver measurable quality, improved patient care—and a healthy practice. 

American economist Theodore Levitt discussed the concept of "marketing myopia" in a landmark article by the same name in a 2004 issue of the Harvard Business Review--and it's a concept that is ripe for application to the health care industry. Viewing the potential for growth or decline in imaging services within a myopic framework looks like this: With time, a radiology group's growth can stall or fail due to its leadership's inability to understand the true and changing nature of its clients, products or services. This is not a failure of leadership, it is a failure of the leadership, and it means even hospitals and radiology groups with good leaders are not immune to the development of a fatal, myopic view of what their true focus should be. 

The Myopic Approach to Imaging
Radiology leadership that fails to take a broad view of the foundational role that imaging plays in the patient care spectrum is opting instead for a narrow view of "product" rather than "service." This is where the issue begins, as we know imaging is in the service business, and not the product business. That service, working in conjunction with hospital administration, clinicians and other health care practitioners, is to deliver accurate and appropriate care to injured or ill patients. In this paradigm, radiologists are part of a team and not in a vacuum, because they play an incredibly important, and therefore foundational, role in delivering that service. 

In a myopic imaging culture, a radiology group's leadership ceases to evaluate or look for cues in the environment that lead to improved satisfaction by the patient care team. The outcome for a group with this viewpoint is the inability to address the care team's concerns and requirements. Instead, that misled group moves toward an introspective, or insular, view of radiology as a product and concentrates more on increased speed, production and efficiency. 

By failing to focus on service, imaging becomes a liability, and ceases to be a change agent for improved patient care, cost containment and a driver for value-added utilization management. 

This "self-deceiving cycle," as Levitt describes it, is one in which a group locks itself into a flawed course of action that appears to be the right choice, but is actually the catalyst behind the group's demise. In radiology, the flaw is the idea that efficiency and productivity are more important than quality, collegiality and service. Once this flaw is embedded in the minds of a radiology group's leadership, that group becomes expendable, and for hospitals, changing to another radiology service provider is usually necessary. 

Consider a Broad Approach to Radiology Service
The questions we ask as we consider courses of action and potential improvements are: 

1. Will this improve patient care and will it result in the clinician being better prepared to treat the patient?

2. Will this answer a client (patient, clinician or hospital administration) concern and will it result in improved quality, lowered cost and/or improved patient care? 

3. Is this designed to improve the group's visibility as a provider of world-class radiology services, will it help differentiate us as unique, and will it be seen by our clients as an enhancement that will have a positive impact on patient care? 

The answers to these questions ensure we keep the focus on our clients, our mission and vision. With this attention to service, and not product, we also demonstrate that what we provide is not a commodity, further separating ourselves from more product-driven groups. 

 

3 ESSENTIALS TO DEVELOPING A PATIENT-FOCUSED CULTURE by Timothy Myers

3 ESSENTIALS TO DEVELOPING A PATIENT-FOCUSED CULTURE

“Culture trumps strategy—every time!” Peter Bartling

Whenever I mention or quote this line, no one looks at me with surprise, and I have never had anyone ask me to explain what it means. Yet the one thing lacking in most radiology groups is a culture that creates and rewards the three essentials required for success in today’s healthcare environment:

  1. The development of entrepreneurial, out-of-the-box thought processes directed at increasing efficiency and effectiveness that drive improved productivity and profitability.
  2. The development of an aggressive, client-driven focus where each radiologist is motivated to develop and implement practices that can lead to gains in patient satisfaction, client satisfaction and retention.
  3. The development of an atmosphere of teamwork, cooperation and collaboration rather than dictatorship, command and control.

Radiologists work day-in and day-out with the processes and activities required to generate interpretations and provide interventional procedures that are high in quality and accuracy. They are in the best position to identify where improved efficiency and productivity may be able to advance patient care and clinician satisfaction. Unfortunately, they are also in the best position to have the greatest tunnel vision when recommending or enacting these changes.

In a previous article I wrote, Radiology Myopia: How Your Radiology Group’s Vision Affects the Hospital’s Bottom Line, we discussed how radiologists can overlook the fact that a radiology group’s product is not an interpretation. Like the old saying, “help is not always helpful,” efficiency is not always efficient, particularly when viewed through the eyes of a client or end-user. We have to support patient care and the patient care team by involving the radiologist as a member of that team.

Radiologists are only part of an imaging team that makes up the larger healthcare organization. Certainly, imaging provides foundational support within the hospital, but it must be remembered that imaging is not an endpoint. Successful patient care is the goal and mission of the healthcare organization. Patients that are treated successfully, admissions that are justified, emergency room turnaround times that are appropriate, and inpatient stays that are in line with expectations are what the healthcare organization requires to be strong. Without meaningful and substantive participation by radiologists and the greater imaging team in the healthcare process, the goals and mission of the healthcare organization, and indeed the strength of the organization, will be significantly lessened.

Radiologist leadership is needed for imaging to remain a foundational key to the health of the organization. In another article, Building a Culture of Success: The Four Critical Components, we discuss the importance of developing a culture of teamwork within the imaging department and healthcare organization. The radiologist should function as a team leader and work with the hospital administration and the middle managers within the department. This will ensure that the potential to make great improvements in patient satisfaction, client retention, overall productivity and profitability are possible. Together there will be greater gains for the organization and ultimately drive growth for the practice, the healthcare organization and the imaging segment in general.

Culture trumps strategy—every time—and I work with radiology groups to respond to this call to action by providing radiologist and imaging team leadership that focuses on and strengthens a culture that puts patients and patient care first.

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A special thanks to Peter Bartling, for inspiring this piece.

BUILDING A CULTURE OF SUCCESS: THE FOUR CRITICAL COMPONENTS by Timothy Myers

BUILDING A CULTURE OF SUCCESS: THE FOUR CRITICAL COMPONENTS /MAY 28, 2015

The term "Radiology Department" is one that is rapidly becoming obsolete. What was once defined as a collection of radiologists is now a complex group of interrelated processes with the principal connection between them being the clients they serve. These clients include the patients who utilize the resources of that radiology department, the physicians and other healthcare professionals who rely on information obtained from them, and the hospital administration and staff who operate and function within these systems. 

This collection of radiological processes and the clients they serve make up a functional segment within the healthcare organization that today, can more accurately be called Imaging. Effectively managing an "Imaging Department" requires an understanding of imaging management that includes not only the end product, but also the end-user. Sustained, long-term success is inseparable from the success of the support team driving the patient, referring physician and radiologist experience. 

In any strong radiology practice, the support team begins with the front desk and clerical staff who answer calls and greet patients and referring physicians as they begin their interaction with the department, either in-person or electronically. Next, are the technologists.  They perform the examinations and prepare the cases for interpretation. Finally, we have the billing staff, who are responsible for properly preparing the patient's bill and answering questions from the patient and third party payers. 

With this knowledge as a foundation, any strong radiology practice could approach such a team culture within the Imaging Department in the following ways: 

1. Honesty
Poor senior management and physician leaders will brush off or deflect questions when the answers are negative. Although answers may be hard to come by, providing as much information as possible, no matter how painful, is always better than silence. Imaging team members don't hate bad news as much as they hate no news. Even if they don't want to hear it, they understand tough decisions must sometimes be made. If the team is aware of the difficulties they face, and hear what is being done to prepare for those challenges; they can go to work with greater confidence, even if they are going into a tougher day-to-day job. 

2. A Bottom-Up Action Plan
A specialty as medically and technologically sophisticated as radiology needs to allow room for growth and experimentation. Many managers who find themselves locked in comfort zones will shy away from trying new workflows, adhering to the familiar adage of "this is the way we've always done it." We believe that if a team member comes up with a great idea, validated by those doing the work, it is prudent for the leadership to give it consideration. Keeping everyone in the loop throughout that decision-making process creates transparency. If the answer ends up being a no-go; be sure to give feedback on what didn't work, and why. Knowing this will motivate the team to come up with alternatives or changes to the original suggestion. 

We recognize that not every idea is successful. The team works just as hard trying new things and being open to radical changes; whether they're a home run or not. Ensuring everyone remains open to growth and experimentation depends on whether the senior leadership rolls with the positive, and occasionally negative outcomes of the changes that are implemented. 

3. Encouraging Feedback From All Channels
When we are considering changes, we ask what is going well and what we could  do better. Hearing nothing, or only that we are not doing anything wrong, is not the same as we are doing everything well. If the team believes something can be improved, we discuss those ideas and have the team work out the needed modifications. 

Next, we solicit suggestions from our patients. You would be amazed at how many of them work in similar process-driven environments and can point out areas where their experience could have been improved. This can also be done via online surveys sent to a patient's email following a visit. This information can furnish the practice with critical data for advertising, such as "over 90 percent of our patients are satisfied with our practice." 

Finally, we take time to listen to our referring clinicians and their staff. Remember, with the exception of the patients we serve, referring physicians are our target clients. Their experience in obtaining information or improving their patient's care through our work will impact what they think about our service.

We have support team members in place to investigate and consider any suggestions that are made. We know that the next great workflow idea could be standing next to one of our radiologists or team members, asking about results or making an appointment for a patient.

4. Creating a Reward Culture 
Providing incentives and the potential for upward mobility within the company are paramount to keeping the best team members happy. While no one person is ever more important than the imaging team as a whole, taking time to appreciate "all-star" moments   sets a precedent that hard work and innovation are appreciated and rewarded. When leadership acknowledges a team member’s actions, it not only keeps the staff working hard, but also incentivizes every team member to reach for individual and group goals. 

When a team finds and implements new workflows and changes, these can be tied to performance goals for departments, individuals, or even those across different sections within the imaging department. Whether it's done through bonuses, team target goals or outside the box rewards like additional time off and flex hours, giving team members and managers a goal to strive for will keep the gears moving and promote an entrepreneurial atmosphere. 

Make no mistake—each of these items is difficult. They require extensive commitment, planning and a cultural shift from the top down of an entire organization. Practices that do these things well will have happy, committed team members for the road ahead and the potential for even greater gains in the new business atmosphere of modern radiology. 

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A special thanks to Frederic Smith, who is the client operations manager for St. Paul Radiology, for contributing to this piece.

WHAT YOU NEED TO KNOW ABOUT MEDNAX’S ACQUISITION OF VRAD by Timothy Myers

WHAT YOU NEED TO KNOW ABOUT MEDNAX’S ACQUISITION OF VRAD

Blog | May 25, 2015 Teleradiology

By Tim Myers, MD

First, let's look at the overall deal. Mednax acquired vRad for $500 million in a cash transaction. This is approximately equal to 10x the EBITDA number provided by unnamed internal vRad sources for the article Newstone, Blackstone’s Credit Arm Hire Credit Suisse to Find Buyer for vRad in March, and discussed subsequently in the Diagnostic Imaging article, vRad Is For Sale. This figure surprised many and is approximately 2.5 to 3 times the amount that many insiders believed that vRad would eventually be sold for.

According to the press release by Mednax and the Dow Jones article, vRad currently generates annual revenue of $185 to $190 million. vRad is reported to have approximately 350 radiologists with customers in all 50 states.

Mednax hopes to use vRad as an entrée to the expected $3.8 billion teleradiology market as well as the broader radiology and imaging market. Mednax CEO, Roger J. Medel, MD, was quoted in the Mednax press release as saying, “We believe vRad is an excellent platform for growth in teleradiology and the broader telemedicine market.” He went on to say, “Radiology is a large, fragmented industry with total revenue of roughly $18 billion, and it is evolving rapidly to include teleradiology as an economic and clinical necessity for customers. We believe the opportunities for organic growth at vRad and for cross-selling between the company’s and MEDNAX’s customer bases are compelling. This acquisition also further broadens the scope of services we can provide to our hospital partners.”

- See more at: http://www.diagnosticimaging.com/teleradiology/what-you-need-know-about-mednax-acquisition-vrad#sthash.q4Tgr0Xx.dpuf  

MATRIX RADIOLOGY: THE END OF RADIOLOGY AS WE KNOW IT by Timothy Myers

MATRIX RADIOLOGY: THE END OF RADIOLOGY AS WE KNOW IT 

The most common complaint heard by administrators regarding radiology is that radiologists do not participate in hospital affairs. The most common complaint heard by clinicians, is that we are not collegial in the way we deliver our services and we are out of touch with what delivering patient care means or requires.

Medicine in the new era of ACOs and the Affordable Care Act is beginning to function in a more fluid, and more open style of collaboration between physicians and hospital administrators. Unfortunately, most radiology services are still rendered in a siloed — or worse, fortress-style — of organization. In the past, the difference between the departments within a hospital and hospital administration itself were not as apparent. In the new paradigm, however, radiology and its introverted and insular practices are beginning to stand out as obstructions to moving forward with new programs and new ways of delivering care.

We define Matrix Radiology as radiology practiced within the matrix of healthcare. That is, within this matrix, each individual physician, healthcare provider, administrator, governmental and third-party payer are interrelated and each contributes to the process of providing high quality medical care.

If radiology is to be practiced in this more collaborative style, we must first remove the barriers that have been erected between radiologists, hospital administrators and our clinical colleagues.

First among these barriers is a lack of communication. Many radiologists believe the report serves as an adequate form of communication between themselves and the clinicians who are performing the medical care in the clinic or at the bedside. This couldn’t be further from the truth. We are participants in that patient’s care whether we are at the clinician’s shoulder or 1000 miles away, connected via teleradiology. In either case, our communication and interaction with that clinician has to be personal and interactive.

Second, our communication has to be in a form that is usable by the clinician. A common complaint is that “the interpretation needs an interpretation.” Clinicians and other healthcare practitioners don’t understand the language we use, the format and structure might be confusing, or frankly, unreadable, and the information provided does not answer the clinical questions or concerns raised. We need to structure our reports so they are easily understandable. We need to provide targeted information that focuses on the question at hand, as well as other information that may be needed for the appropriate treatment of the patient — and we have to be more specific in our impressions and conclusions. After all, as consultants we are paid to say what we think, not give a list of abnormalities, or a list of differential diagnoses provided without context.

Next, we have to become more collegial. Collegiality is frequently interpreted as being friendly, but the definition actually means “having shared, or sharing, responsibility within a group.” In the case of medical care, this means radiologists and clinicians are not only working together in a pleasant and productive atmosphere, we are also sharing in the responsibility of treating the patient appropriately and efficiently. It also means we are approachable and responsive to one another’s needs and concerns.

Finally, we must be available to the hospital and to the hospital system for efforts that will lead to improved efficiencies within the department, as well as improved healthcare within the community. This means we should participate in the marketing of programs that will help patients who are at-risk or high risk, or may be in areas of chronic care. These patients are at their most malleable and need a concerted effort by the health community (e.g. all of those within the matrix) to ensure the appropriate utilization of services, providing high quality and compassionate care at the lowest possible cost.

Matrix Radiology will be the way progressive radiology groups function going forward. It brings radiology and radiologists into the next generation of healthcare by encouraging them to become partners with clinicians and hospital administrators in order to provide the best possible healthcare for their communities. Finally, providing radiology within the healthcare matrix enhances the profiles of radiologists and the specialty of Radiology.

TIS THE SEASON…FOR MERGERS AND ACQUISITIONS IN RADIOLOGY by Timothy Myers

TIS THE SEASON…FOR MERGERS AND ACQUISITIONS IN RADIOLOGY

Diagnostic Imaging

Blog | April 29, 2015 Practice ManagementTeleradiology

By Tim Myers, MD

Amid the hype and public relations blitz of the announcement of the Aris acquisition of Optimal, is there only light, or is there perhaps some heat as well?

With more than 160 radiologists, this deal creates the second largest grouping, if not group, of radiologists in the U.S. With these kinds of numbers, the roles of the radiologist leadership in this mega-imaging conglomerate become paramount. Whether you are for or against this acquisition or any such increased corporate move into imaging and radiology, the one clear bright spot in the deal is the chief medical officer (CMO) for Optimal, now Aris, Chad Calendine, MD.

According to the press releases,  Calendine will be maintaining his role as CMO within the new organization, with perhaps some between-the-lines hints of new potentials ahead. I had a chance to talk with Dr. Calendine about his view of radiology and the current landscape within radiology.

- See more at: http://www.diagnosticimaging.com/practice-management/tis-season-for-mergers-and-acquisitions-radiology#sthash.IKpdgnAr.dpuf  

VRAD IS FOR SALE: WHAT DOES THIS MEAN FOR RADIOLOGY? by Timothy Myers

VRAD IS FOR SALE: WHAT DOES THIS MEAN FOR RADIOLOGY?

Diagnostic Imaging

Blog | March 27, 2015 TeleradiologyPractice Management

By Tim Myers, MD

On March 12, 2015, an article published on Dow Jones’ Private Equity & Venture Capital news and data portal reported that Newstone Capital Partners and Blackstone Group’s GSO Capital Partners had retained Credit Suisse Group to begin the sales process for Virtual Radiologic (vRad). This ends months of insider speculation regarding the future of the largest corporate provider of national teleradiology services, which began to surface even before RSNA in November 2014.

The article, “Newstone, Blackstone’s Credit Arm Hire Credit Suisse to Find Buyer for vRad,” suggests vRad’s slow march to the auction block has been anything but inevitable. But despite merging with Nighthawk Radiology Services via Providence Equity Partners in 2011, along with other advantages, the article goes so far as to describe “years of turmoil,” decreasing profit margins, and “client attrition [that] nearly drove the company to bankruptcy protection,” with equity from Providence being “largely wiped out.”

- See more at: http://www.diagnosticimaging.com/teleradiology/vrad-sale-what-does-mean-radiology#sthash.dSqEKkAc.dpuf

​Is Teleradiology Right For Radiology? by Timothy Myers

Is Teleradiology Right For Radiology?

Diagnostic Imaging

November 19, 2014

 Blog  | TeleradiologyPractice Management

By Tim Myers, MD

As we prepare to mark the yearly vigil known as “RSNA”, during which we revisit all aspects of radiology, a recurring question remains, “Is teleradiology right for radiology?”

The question seems simple enough, yet some authors and speakers continue to make a virtual (pun intended) living rehashing the issues and non-issues of when and how to use teleradiology or a teleradiology company. In these discussions, teleradiology typically gets painted with the same old brush. The problem is, the reasons given for denouncing teleradiology haven’t dealt with the complexities of the radiology landscape or taken into account the diversity of the options now available.

At one time, teleradiology options were limited. That is not the case today. As with many other segments of the economy there is a resurgence of individual entrepreneurship. New providers are entering the market that are wholly radiologist-owned and have an interest in partnering with on-site groups. These new groups work directly with their on-site partners to provide high quality services and interpretations. This synergetic relationship improves patient care, improves clinician satisfaction, utilization, and decreases cost.

In the past, the teleradiology provider was a lesser partner at best or a low quality, low cost option for overnight coverage at worst. These new teleradiology companies are pushing for a complete reevaluation of how teleradiology and on-site radiologists can work together. Being run by radiologists and coming with a unique vision, these new providers are earning a seat at the patient care table with their on-site colleagues. This dynamic, transparent partnership demonstrates bilateral support between the teleradiologist and on-site radiologist to both hospital administration and clinicians. This improves radiologist visibility and demonstrates a motivated and concerned approach to patient care, 24/7.

- See more at: http://www.diagnosticimaging.com/teleradiology/teleradiology-right-radiology#sthash.5MuGjRgV.dpuf