Size matters: How one large radiology provider is using scale to solve the value equation
The size of an imaging practice can prove powerful in moving the needle on quality initiatives, according to a new case study.
Leaders at Radiology Partners recently detailed how they’re harnessing their considerable scale to improve care delivery. The California company—which employs more than 1,500 physicians in 24 states—is doing so through investment in data, analytics, project management and machine learning. All are geared toward “creating clinical value for our patients,” Chief Medical Officer Jay Bronner, MD, and colleagues wrote in March’s Journal of the American College of Radiology.
Rad Partners expects the merger movement to continue in the specialty and believes imaging stands to benefit.
“Much like the consolidation trend of hospital systems and payers, the impetus for physician practice consolidation is largely due to industrywide changes like new payment models, pervasive government compliance regulations, and increasing IT and infrastructure costs,” Bronner et al. wrote March 2. “Larger practices have the ability to withstand these and other challenges and also have the resources to shape the future of radiology by focusing on improving quality and driving clinical value.”
One way Rad Partners is harnessing scale and making gains is through its Best Practice Recommendation program. Designed to use the most up-to-date, evidence-based guidelines, the effort focuses on reducing variability and unnecessary utilization while saving patient lives. There’s also a concerted effort to avoid burdening radiologists, the authors added.
Referring physicians or Rad Partners docs make recommendations for new quality goals, which the clinical team then considers for feasibility in the program. And a radiologist who serves as director of clinical quality further collaborates with partners in academia to refine the new best-practice and ensure that it’s practical, clear and relevant. And a team of imaging experts in the practice also provides feedback on an early draft.
Once a new Best Practice Recommendation is finalized, Rad Partners disseminates them to local practices across the U.S. To maintain autonomy, the company makes implementation of new goals optional, however, all recommendations have been universally adopted to date, Bronner noted.
After adoption, radiologists receive video training on the new recommendation and its rationale, with the chance to earn CME credit. Practices then collect data to track performance and adherence, with leaders receiving monthly updates. “This regular feedback has been instrumental in maintaining and improving radiologist adherence with the BPRs,” the authors wrote.
Findings now tagged for follow-up in the program include incidental thyroid nodules, ovarian cysts and abdominal aortic aneurysms, among others. But with the list ever-growing, Rad Partners has also deployed the use of artificial intelligence to ensure adherence. The AI-guided assistant analyzes a radiologist’s report in real time as its dictated, pinpointing whether there’s a relevant recommendation and providing physicians with guidelines for that specific patient and exam. All is done without disrupting workflow, the team emphasized.
The AI helper has proven powerful—with average adherence to BPRs sitting at 71% before, and nearly 86% six months after implementation. And the new goals seem to be improving quality, too, decreasing AAA rupture rates by 19% after two years at two Rad Partners practices, for instance.
“Creating a successful tool is not a given,” Bronner and colleagues emphasized. “A substantial investment in time, effort and finances is required—the combination of which is afforded by scale of a large practice. This is one example of how a large practice, which is willing and able to invest the resources, even when a short-term return on investment is not present, can improve clinical value.”
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.