Empowering radiologists to track referral trends using 'do-it-yourself' business intelligence tools
Radiologists can utilize self-service business intelligence to closely monitor referral patterns and collaborate with clinicians who commonly order their services, experts charged in a new analysis.
Such tools have previously been used in the specialty for everything from improving scanner productivity to tracking patient satisfaction. The University of Washington in Seattle has seen promise in placing business intelligence instruments in specialists’ hands, allowing them to access radiology information system data and draw conclusions.
Radiologist Puneet Bhargava, MD, and colleagues believe new payment models and strained revenue streams during the pandemic present compelling reasons for physicians to dive into “big data.”
“The radiologist in the reading room now plays a vital role in how value-based care is dictated,” Bhargava, a University of Washington professor and editor-in-chief of Current Problems in Diagnostic Radiology, and colleagues wrote Nov. 28 in JACR. “Instead of being kept in the dark by hospital management, radiologists should be empowered to use self-service BI tools and be given access to business analytics data. Information that was previously only privy to operations staff could change the behavior of radiologists, incentivizing them to increase their interactions with referring clinicians.”
Bhargava et al. detailed how their own institution utilized self-service business intelligence to understand ordering trends, pinpoint opportunities for strategic partnership, and expand the department. For their study, researchers obtained all outpatient exams interpreted by the University of Washington’s abdominal imaging section at its academic medical center and neighborhood sites between 2009 to 2019. Radiologists involved in the project had zero experience with database management or analytics. They created data visualizations to understand outpatient trends, including the studies most commonly referred to the section, top 10 providers ordering cross-sectional abdominal imaging, and common study-indication keywords.
Bhargava said their data mirrored national numbers highlighted in previous analyses, with CT, ultrasound and MRI showing “robust” increases in use. Computed tomography was the main driver of upticks in cross-sectional imaging, and oncologic staging studies accounted for the largest percentage of exams referred to the section. Obstetric and gynecologic ultrasounds and abdominal MRIs were the next highest on the list. Referring providers and specialties appeared to remain consistent over the 10-year study period, and fluctuations usually stemmed from referrers leaving the hospital system. Gastroenterology (for hepatology and transplants), nephrology (mostly for renal transplants), urology and general surgery were the biggest referring specialties. Keywords matched such trends, focused on cancer staging or surveillance.
“Although the abdominal imaging section at our tertiary medical center has always had a close relationship with providers in the gastroenterology, nephrology, and urology departments, we now know that they are the top drivers of our outpatient business,” the authors noted. “During times of staffing shortages, multidisciplinary conferences catering to our primary referring providers should be prioritized, such as those from hepatology,” they added later.
The authors also identified fluoroscopy as an important area of focus. University of Washington’s abdominal imaging section has seen steady growth in this segment at a time when there’s been nationwide declines in gastrointestinal and genitourinary fluoroscopy delivery. Bhargava and co-authors credit this to their radiologists’ “concerted effort” to build trust with ordering gastro docs and urologists, “carving out a niche service for their specific needs that continues to provide valuable information for patients at a lower cost.”
“To remain competitive, radiology departments need to know whether community needs are currently being met,” the authors charged. “Using these data, we can approach referring sections to have open and honest conversations about areas for improvement and imaging currently outsourced to our competitors,” they added later.
You can read much more in the Journal of the American College of Radiology here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.