When Hurricane Sandy and its aftermath devastated New York, New York, in October 2012, perhaps no one was more vulnerable than the patients needing care in area hospitals. Eli Tarlow, CIO of the city’s Bellevue Hospital Center (BHC), recalls, “It was the best of times and worst of times—a natural event that no one could have prevented. You really see the best of your staff in moments of crisis, and that held true during Hurricane Sandy. Staff members at all levels volunteered to do anything necessary, from bringing needed supplies up and down many flights of stairs to helping with preparing or delivering food for patients. Nothing came between the employees and the work that needed to be done to maintain patient care.”

Jeff Maze has spent his career attempting to solve the conundrum at the core of business intelligence and analytics: the more data there is, the harder it is for operational leaders to understand and act upon. “Everyone has data. This is the era of big data,” Maze, who is senior manager of business intelligence at Zotec Partners, says. “But data does not mean the same thing as information. The key is taking data and making it timely and actionable, baking your own insight and experience into it, and turning it into wisdom.”

Radiology’s business environment has changed considerably since the heyday of the late 1990s and early 2000s, when the equation for success was comparatively simple, Paul Staveteig, MD, says. “Now, the environment is different,” he explains. “The only way to survive in this marketplace
is to be able to look at things very critically and make decisions very quickly.”

Imaging Healthcare Specialists (“IHS”), a 30-radiologist practice based in San Diego, California, has a simple ethos driving its business decisions. “We view ourselves, first and foremost, as a medical practice,” Thomas Cleary, president and COO of Imaging Health- care Specialists, explains. “Every day, every employee who works for us is making an impact on patients’ lives.”

Medical practices have arrived at a juncture where the importance of business intelligence to strategic planning and growth cannot be ignored, says Scott Law, founder and CEO of Zotec Partners. “Physicians are, first and foremost, scientists, and historically they have focused on the science of their discipline as opposed to the business side of medicine,” he says. “In the current environment of evolving health care delivery and reimbursement models, the key to survival is finding ways to differentiate yourself—not only through productivity and efficiency, but also through quality and improved outcomes, which we are really beginning to be able to measure for the first time.”

Of all the outsourcing decisions that radiology practices must make, none might take as long as deciding whether to outsource medical billing and coding. This is due, in part, to the fact that billing is the company’s cash register, so to speak, and is therefore more likely to be scrutinized —even agonized over—than are other services.

The federal meaningful-use program has been particularly challenging for imaging, both in its inception and in its execution. Initially, it seemed as though radiology would be exempt from the system of incentives and penalties devised to increase electronic health record (EHR) adoption; a rule change reversed that, making 90% of practicing radiologists eligible providers. For specialists, however, the menu set of requirements can be puzzling, at best, and prohibitive to participation, at worst.

The theme of 2012’s annual RSNA meeting in Chicago, Illinois, was Patients First, reflecting a question on the minds of many in the imaging community: How can a specialty with very little patient interaction built into its workflow improve its service to patients? As an emerging practice model, patient-centered radiology has a nice ring to it, but as Greg Thomson, CPA, executive vice president with Medical Management Professionals (MMP), notes, “This represents a major cultural leap for radiology. Radiologists have long had multiple customers—including referring physicians and hospitals—along with patients, and because they often do not interact with patients, their focus has been on the referring physicians, not the patients. It is a mindset shift for the specialty.”