At two Houston-area hospitals, we recaptured patient volume in our diagnostic imaging departments that was migrating to corporate- and physician-owned competitors. In addition to reviving the imaging volumes, we exceeded budgets in that department by more than 10 percent throughout multiple financial reporting quarters. In my role as an administrator focused on business development at a freestanding community hospital and a for-profit hospital (that was part of a large national chain), I led teams using similar strategies to successfully increase patient volume in the hospitals’ imaging departments. First, I worked with the hospitals’ leadership to determine reasons for the decline in our imaging patient volume. We concluded that faster scheduling and more efficient handling of new patients at corporate-owned and physician-owned imaging facilities in the area was drawing patients away from our imaging services. Initially, some team leaders recommended buying new software to improve the patient scheduling challenges. However, covering the costs of the software was a concern. We were not certain if the loss in volume resulted from a need for new technology or from permanent changes in healthcare delivery trends that would continue in the future regardless of a software investment. We needed an alternative strategy. We decided to examine our processes and identify areas for improvement that could boost volume at little to no cost. Without taking on additional expenses, projected growth in patient volume would go directly to the hospitals’ bottom lines.
In both markets, we formed multidisciplinary diagnostic imaging volume development teams that met every two weeks to assess what was necessary to compete with the corporate- and physician-owned centers. Each team included radiologists, a medical director, an imaging administrator, an MRI/CT manager, MRI/CT/other imaging techs, a business office manager, a scheduling coordinator, a marketing director, physician liaisons, a CFO, and other officers including the CEO. Instead of finding fault or casting blame, team meetings fostered a sense of collaboration and emphasized compassion for patients and a concern for the future of the imaging departments. We knew that the traditional hospital delivery model was under fire and changes might be uncomfortable for some hospital staff. However, maintaining our current processes wouldn’t improve patient care or the health of our imaging business. Our teams asked a root question: Why are customers choosing the corporate- and physician-owned facilities? The teams concluded that those facilities could get patients in faster for their X-rays and tests, which was a critical differentiator. In each case, the teams believed that their hospitals had a quality edge over the corporate- or physician-owned facilities, so they set out to make organization-wide changes to address this lack of speed and turn the hospitals back into providers-of-choice for customers.
We made the following changes at the two Houston-area hospitals that resulted in significant increases in patient imaging volume.Filled immediate holes in the schedule. When customers called to book an imaging appointment, schedulers were suggesting dates a few weeks in the future. This was easier for the schedulers than looking at the schedule for the next few days and suggesting specific open times. Unfortunately, such an approach left near-term holes in the imaging schedule. In addition, this approach generally was not in the best interest of patients who usually prefer to receive their MRIs or mammograms as soon as possible. We instructed schedulers to try to fill the immediate holes in the schedule and explained to schedulers why this approach was important to the hospitals’ imaging businesses. Prepared the business offices for quicker pre-certification turnaround. Because schedulers were now filling immediate open times in the schedule, the business offices at both hospitals needed to pre-certify patients for insurance coverage more quickly than in the past. Rather than having two weeks to conduct that process, they might only have two hours if an appointment was made on the same day the customer contacted the hospital.Added hours of operation. We added Saturday imaging hours to create more scheduling capacity and better accommodate the schedules of today's consumers. The additional hours also improved our competitive advantage because patients are more likely to select providers that offer convenient hours.Assigned imaging employees to physicians and offices. We asked imaging techs, who served on the imaging committee, to acquaint themselves with specific physicians and their office managers and office nurses to personalize the scheduling experience. For example, after imaging techs developed relationships with a physician’s office, the office managers calling with a question or to schedule an imaging appointment had confidence that their request would be handled competently. That confidence in the hospitals’ imaging staff also increased the number of patient recommendations that physician managers and nurses made to the hospitals’ imaging departments.We also found another benefit to building relationships between imaging techs and physicians’ offices: The imaging staff reported greater satisfaction in their work because they were helping people they knew personally. Notified physician offices of schedule openings. Physicians’ offices expected that the hospitals would take longer to schedule imaging appointments, so they directed patients wanting faster service to the corporate- and physician-owned centers.To ensure that physicians’ offices knew our hospitals could deliver timely services, we started using fax blasts to inform physicians’ offices when same-day appointments were available. When physician office managers or office nurses arrived in the morning, a fax was waiting with imaging appointments available that day. We also encouraged imaging techs to call their assigned physician office managers and office nurses early in the morning to inform them of open afternoon appointment times. Those notifications attracted patients who saw their physicians in the morning and wanted to receive their imaging results that same day. Scheduled multiple tests in a single visit. If patients required multiple tests, schedulers would try to complete all tests in a single visit as part of the overall efforts to better meet customer needs. For instance, lab work would be scheduled the same day the patient arrived for an imaging study.Encouraged fast turnaround from radiology. Whenever possible, the hospitals’ radiologists would send imaging results back to the referring physicians on the same day of patients’ appointments. This improved physician and patient satisfaction. Suddenly, we were doing a better job at satisfying our medical staff, the physicians, and our patients.Assessed volume by physician—and shared the results. We identified which physicians were taking advantage of the new approach to scheduling imaging appointments. Those results were shared with the imaging team members as evidence of the success of their efforts,which served as additional motivation to bring about improvements. Soon, these satisfied physicians began sharing with their colleagues how our outpatient imaging services had improved. This favorable feedback led to other physicians, including historically low utilizers, to refer patients to the hospital's outpatient imaging department for prompt, high-quality outpatient services. As in other businesses, satisfied customers can become your greatest sales force.
By meeting the needs of multiple customers—patients, physicians’ offices, and hospital colleagues—the diagnostic imaging departments at the two Houston-area hospitals recaptured lost volume and exceeded budgets. Our all-hands-on-deck approach allowed both hospitals to overcome a declining diagnostic imaging business by improving scheduling, extending service hours, and developing relationships with physician offices.
Darrell Pile, MHA, is an executive advisor for Outpatient Healthcare Strategies.
J.P. Morgan: Managing Cybersecurity and Protecting Patient Data
Brian DiPietro, Managing Director, Commercial Bank Technology, JPMorgan Chase & Co., discusses the importance of evaluating your cybersecurity protocols to help prevent malicious data breaches.
TransUnion Healthcare: Smarter Revenue Cycle Solutions
Gerry McCarthy, President of TransUnion Healthcare, discusses industry trends contributing to higher bad debt and what to do about them. Gerry is responsible for the strategic direction of the healthcare business and expanding its footprint in the healthcare market overall. He has more than 20 years of experience in healthcare information technologies.
Deloitte: Creating Value with Effective Care Management
Scott Kolesar, principal and senior leader in Deloitte Consulting LLP's Value Based Care practice, and David Wennberg, MD, MPH, adjunct associate professor of The Dartmouth Institute and former chief executive officer, Northern New England Accountable Care Collaborative, discuss the challenges and competencies involved in creating a care management organization.
American Express: Streamlining Supplier Payments and Boosting Revenue
Andrew Jamison, vice president in the Global Corporate Payments division of American Express, discusses trends and opportunities in supplier payments.
Deloitte: Realizing the Potential of Your CDI Program
Suzanne Whitworth, director at Deloitte & Touche LLP, and LaVerne Romberger, MSN, CCM, CCDS, clinical operations manager-Seton Healthcare, share leading practices for maximizing the potential of clinical documentation programs under value-based care.
RevSpring: Customizing a Technology Platform to Drive Patient Payment
Martin Callahan, Senior Vice President, Healthcare Solutions, RevSpring, describes key industry trends affecting how patients engage with the revenue cycle and ways payment processes are changing as a result.
KPMG: Readying for Healthcare Today and Tomorrow
Dion Sheidy, a partner in KPMG's Healthcare Advisory practice, discusses healthcare's changing landscape and how having the right advisor can help organizations navigate challenges and opportunities.
Huron Healthcare: Readying Your Organization for Transformation
Gordon Mountford, executive vice president, Huron Healthcare, discusses business imperatives for undertaking transformative change.
Xtend Healthcare: A Custom Approach to Optimizing Revenue Cycle Performance
Tom O'Neill, CEO of Xtend Healthcare Advanced Revenue Solutions, discusses key areas where organizations risk revenue leakage and ways they can use outsourcing to better protect cash flow and support accurate payment.
KeyBank: Helping You to Realize Your Strategic Vision in Changing Times
Victoria Terekhova, senior strategist for Enterprise Healthcare at KeyBank, discusses key challenges when developing long-term strategy in a rapidly changing industry, and the role the right banking partner can play in helping healthcare providers navigate the opportunities before them.