The Virtual FTE: Radiology’s flexible, scalable teammate

Rare is the radiology practice of any size that has never had to sweat out the absence of one or more radiologists as unread non-emergent studies piled up. Today, a solution is as close as the cloud, where a radiologist—board-certified in every subspecialty and licensed in all 50 states—resides. This versatile professional is on call 24/7 and needs no work breaks, employee benefits or administrative support.

For that matter, the radiologist in the cloud doesn’t even notice when you neglect to say “Good morning” and “Good night.” That’s because this individual is, in fact, a well-rounded squad of radiologists combining forces to work as an integral member of any practice’s team through vRad’s Virtual FTE program.

“Virtual FTE has enabled the market to tap into our services in a much more strategic way,” explains vRad COO/CIO Shannon Werb. “We are helping groups right-size to any situation at any time.”

“Maybe you need to fill the gaps for MSK interpretations during the day, which is about a third of an FTE,” continues Werb, “but you also need general radiology the rest of the time. You can now get all of that from vRad for less than the cost of a full-time radiologist working on site.”

The idea has been catching on since vRad launched Virtual FTE last spring. The company reports that more than 50% of the new business it earned during the first quarter of 2016 came through the new program.

“For a long time, teleradiology was all about emergent and preliminary reads overnight,” Werb says. “Now reduced reimbursement and other market forces are driving practices and hospitals toward teleradiology for final reads, including for complex MRI and PET/CT studies. That shift was a big part of what led us down the road to adding Virtual FTE to our continuum of services. It’s all about keeping up with what people need right now.”

Virtual staffer, actual value-add

The American College of Radiology has estimated that a staff radiologist needs to bring in $515,000 per year just to cover his or her own salary, employee benefits, malpractice coverage and other expenses, according to Werb. Faced with that economic reality, many practices and hospital departments turn to locums. But that choice often ends up costing upwards of $2,000 per day and can bring through the door questionable quality, so-so productivity and irregular availability.

These truths had a role in pushing vRad to launch its Virtual FTE solution. Werb describes a recent customer meeting that illustrates the program’s value on the ground.

An eight-radiologist customer that had been partnering with vRad for preliminary reads recently lost half its radiologists for various reasons. “They could no longer keep up with their main hospital client’s expectations,” Werb says. “Plus, they had other contracts that were affected.”

A vRad advisor showed the group that it could cost-effectively move from preliminaries to finals with vRad, while also taking on additional volume “just by our adjusting the roster that we have for them through Virtual FTE,” Werb recalls.

“Because of our fee-per-study model, the client pays for only what they send to us to read,” Werb explains. “They don’t have to go recruiting—which can be a serious challenge in these days of fewer medical students choosing radiology—and they are out of danger of losing their hospital contracts.”

Along with staff falloffs due to retirements, relocations and attrition, the other scenario that makes a radiology practice a good candidate for Virtual FTE is one in which a practice is strong, growing and only being held back by a lack of flexibility, especially when it comes to subspecialty resources.

“We can bring significant resources to augment their recruiting by supplying that virtual fulltime equivalent, which is potentially backed by 20 or 30 subspecialty-trained doctors in the cloud who are accessible 24/7,” Werb says. “Plus, with all the potential threat of consolidation within the market today, some of our growth-minded customers need a source of stability. They see vRad’s Virtual FTE as a true growth model.”

Heads in cloud, patients in mind

So far, most customers availing themselves of vRad’s Virtual FTE are medium to large group practices. However, says Werb, smaller groups open to new ways of doing things stand to benefit too—as do hospitals that employ their own radiologists.

“We have a four-hospital system that went from employing 22 radiologists to employing only 11 last year,” Werb says. “They hired a certain number and sent the rest of the work to us through Virtual FTE. During their hiring period, they sent hundreds if not thousands of studies to vRad all at once. We got them out of a huge bind.

“That hospital system is opting to stick with Virtual FTE for the foreseeable future as it continues to right-size their department and position themselves for growth. This is the impetus behind Virtual FTE—it allows radiologists to focus on building their practices and relationships with hospitals by covering shifts they don’t want or fill critical subspecialty gaps like breast imaging or MSK.”

“Virtual FTE is being enthusiastically received everywhere,” Werb adds. “We are now helping radiology groups and departments meet the needs of their referrers, and we’re helping the patient-facing physicians provide better, faster, more efficient care.

“Regardless of whether we are providing this for a group or a hospital, the final end recipient is the patient. There’s no doubt the patient is getting better care overall because of Virtual FTE.”

Changing face of teleradiology

Werb says that at the one-year milestone, Virtual FTE epitomizes a central concept in the mission and vision of vRad, the practice has more than 400 radiologists and operates what likely is the biggest and most highly developed PACS in the world."

“The solutions that we bring to the market should not always be about the technology behind our work,” he says. “What I like most about Virtual FTE is that the technology is a facilitator in such a way that we really don’t even talk about it. There’s a lot going on here to make it happen, but the benefits are all clinically and operationally focused. The program is all about taking great care of the patient.”

Additionally, Werb notes, the program reflects the changing role of teleradiology as a practice model, helping U.S. healthcare improve population health while cutting out excess cost.

“In the early days of teleradiology, it was a luxury prelim-reading service in the middle of the night,” he says. “To some groups, it was kind of a threat for a while. I think we are now at the point where you are seeing groups embracing teleradiology as a strategic option for them to be stronger competitors in their respective markets.”

“Virtual FTE is an excellent representation of where the market is heading,” Werb concludes. “And we are happy to be helping drive it there.”