The Value of Imaging for Patient Care – A Commitment from the Top
The Department of Radiology and Health System administration have forged a partnership with value for patients at the center.
Dec 20, 2018 10:30 AM
By Michael Mozdy
When a single MRI machine can cost $3 million, and ongoing yearly maintenance on that one machine is $500,000, you can imagine how radiology budgets can seem like a necessary evil, especially in a system with four hospitals and over a dozen community health centers. Yet the power of expert imaging in a sophisticated academic medical center like ours is undeniable. MRI, PET, and CT are the most accurate and dependable tools for diagnosing injury and disease, and they are increasingly used to help doctors monitor how treatments are progressing and change tactics if needed. In short, they’re the backbone and the engine for advancing medical care, and systems that employ a long-term strategy for their use can provide better patient care.
Thankfully, the leadership of University of Utah Hospitals and Clinics have cultivated an excellent working relationship with the Chair of Radiology and Imaging Sciences, Satoshi Minoshima, MD, PhD. Together, they have centralized the complex planning and management of all radiology resources under one, collaborative umbrella. They call this decision making structure IMAGER: Integrated Management And Guidance for Enterprise Radiology.
It’s a very innovative model, and something unique for academic medical centers. Often, departments in a School of Medicine compete with each other and the hospital system for a limited amount of health system revenue, attempting to get as much funding as possible for their particular needs. In the case of a capital-intensive department like Radiology, such competition and siloed thinking makes for a troublesome environment.
Not so at the University of Utah. Over the past three years, Minoshima and leaders like Gordon Crabtree, Hospitals and Clinics Chief Executive Officer, and Dan Lundergan, Hospitals and Clinics Chief Operating Officer, have worked diligently to align their thinking, their needs, and their commitments.
“We are trailblazing a new way of doing business,” declares Minoshima. Their team, consisting of a “triad” leadership model from Hospitals and Clinics, the Department of Radiology and Imaging Sciences, and the Office for the Senior Vice President of Health Sciences, has been ambitious in their goals. Minoshima breaks down the many benefits of IMAGER. “We have been able to consolidate professional and technical operations, finance, and accounting, not to mention spending and management for capital costs, reserve, services, supplies, and other business innovations such as Radiopharmacy operations,” he says.
The members of the IMAGER committee meet bi-weekly to review the utilization of equipment, clinical staff, physicians, overhead, and more to best budget for present and future needs. All clinical facility and physician payments are then pooled to collectively pay for the needs in all areas of Radiology and Imaging Sciences.
“We’re looking at the overarching clinical enterprise as a business,” explains Lundergan, “instead of having a department appear only during the budgeting process, looking to fund this year’s latest and greatest equipment.” For a COO like Lundergan, keeping the various entities in our health system healthy and focused on shared goals is very important. “IMAGER is a good way to align the clinical enterprise in order to meet our goals: the exceptional patient experience, unmatched quality, and financial strength.”
Lundergan and Crabtree note that such a partnership is especially important for such a capital-intensive department like Radiology. Not all departments in the School of Medicine require such expensive, sophisticated equipment and support staff to accomplish their work. Every new community health center or facility expansion requires some amount of budget for Radiology – after all, diagnosing disease and injury is often based on ultrasound, x-ray, CT, MRI, and PET technology.
But Crabtree notes that it’s more than just the business needs of Radiology. “It is both the business and the coming together of personalities and cultures,” he asserts. “You have to have someone like Dr. Minoshima who has that alignment approach.”
Lundergan agrees. “Dr. Minoshima has a great sense of value to the system. He’s good about thinking through the economic impact of our decisions and the changes facing health care such as fee for service and population health. It’s been great to have someone with his talent and personality.”
In other words, IMAGER has been able to reduce waste and clearly articulate the value that imaging brings to the health care enterprise. When faced with decisions about future directions for imaging technologies, the IMAGER team can make clear, metric-driven choices rather than educated guesses.
For his part, Minoshima couldn’t be more clear about his feelings. “This is the best system I’ve ever been involved in when it comes to this collaborative and integrated relationship,” he claims. “I am very appreciative and impressed by our collaborative hospital leadership and their integrity as partners.”
“Everything is so much more transparent and clear,” says Dasha Runnions, Radiology and Imaging Sciences Chief Administrative Officer. “Now that we’re operating in this way, I can’t imagine going back to the old way of doing business.”
Crabtree reflects upon the fact that IMAGER started as a pilot project and says that it’s likely to be a permanent solution. “We often discuss and plan for the future of health care,” he says. “The difference with Radiology is that we’ve actually put into practice our ideas about alignment and future. We actually have an outcome.”
Michael MozdyMichael Mozdy is the Senior Science Communications Editor in the Department of Radiology and Imaging Sciences.