Imaging Managers: Focus on Patient-centered Care

As a former imaging administrator with a clinical background in both nursing and radiology, I am no stranger to continuing education and conferences. Having attended almost every major imaging conference from the RSNA to the AHRA over the past twenty years, I have seen a lot.

My new first is the “virtual” conference.

Attending the Association for Medical Imaging Management’s (AHRA) second annual virtual fall conference held Oct. 14^th through 28^th, I was reminded by CEO, Edward Cronin, that this was not simply going to be a webinar. With over 200 imaging professionals signed up initially and the opportunity for its 5,300 members to join at their own pace, the conference offered many firsts for me including live keynote speakers as well as a live Q&A for all sessions, interactive demos with vendors, and the storage capability to host all recorded materials until December.

And I never even had to leave my home or put on work clothes.

Using a multi-dimensional approach, the AHRA fall conference was like a mini RSNA 2016 preview, demonstrating the growing importance imaging plays within the overall structure of health care. From Ezequiel “Zeke” Silva, MD’s keynote presentation on payment policy and its direct relationship to patient-centered care to Kent Hudson, MD, CPE, discussing the future of data driven decision making, an expert panel offered a 360-degree view of the challenges imaging leaders face today.

Unlike conferences of my own yesteryear that focused heavily on only one branch within imaging, such as the administrator’s role or the technologist’s role; the AHRA fall conference demonstrated a trend that I have come to know well within the last year of reporting on imaging topics; physicians and administrators create the most effective outcomes when they share information collaboratively. While the conference offered valuable updates on Joint Commission standards, breast imaging practices, and regulatory affairs, patient experience trends and operational efficiencies were some of the key areas highlighted.

The Elevation of the Patient Experience is Vital to All Areas of Operations
“I am not sure if we can remain relevant within new payment models if we cannot embrace patient experience and patient centered care," said Silva, during his keynote presentation. As the head of the ACR Commission on Economics, Silva has studied and written in length about granular as well as broad changes that have taken place in the way hospital and physicians are paid. Discussing the implementation of many quality initiatives that have been tied to payment since 2000, the Affordable Care Act along with MACRA changes in 2015, has shifted the focus away from fee-for-service to alternative payment models (APM) resulting in hospital payments affected by how well radiologists do. These new models expect interoperability, he said.

Shifting to models where the hospital is paid one amount for an entire episode of care, Silva said: “Radiology touches almost everything and we are in a position to implement change at many levels.” By always keeping the patient’s needs at the forefront of all decision making; collaboration, teamwork, and partnership are critical. Making personal introductions to patients, engaging radiologists, being purposeful that what your organization offers is what they can also give, and making sure that there is quality care from the efficiencies of scans to benchmark data that differentiates is essential.

Delving deeper into the patient experience, Toby Edwards, BS, CRA, RT(R), director of imaging services at Lake Wales Medical Center in Florida, found that, in his own analysis of HCAPS star rating systems, what separated good organizations from great with five star ratings involved their level of accommodation. Understanding that well-running hospital systems use patient-centric tactics, Edwards said: “Customers are very sensitive to whether someone wants to help them,” and hospitals should create processes to fit patient preferences.

In his session on the “Art of Accommodation”, Edwards explained staff’s acceptance of inconvenience, passionate desire to satisfy, correlating hard work to job satisfaction, anticipating needs, and an intelligent focus on quality instead of quantity creates powerful results. Not only will quality scores rise, but staff can also accomplish more with less effort and work smarter, he said adding that accommodation in action also produces gratitude, a positive word of mouth, and creates loyalty.

“Too often patient experience gets wrapped around HCAPS scores or other metrics,” said Sean Keyser, VP, patient experience, Novant Health, who said: “It’s not just about getting a nine or ten on a survey.”

“Efficiency plus empathy equals the human experience,” he said.

 Considering not only the patient but the team’s needs as well, the human experience should be spirit lifting, indelible, and soul jogging, he said. Compassionate connected care comes from understanding that anxiety is suffering, caring transcends diagnosis, body language is important, and autonomy reduces anxiety, he said.

Operational Efficiency and Growth Create Effective Models of Care
The ultimate end goal is that organizations want patients to recommend their services.

“We are in a consumer retail business now that opens us up to the deadly threats of distraction, competition, and becoming a commodity,” said Cathy Dolan-Schweitzer, MA, president of Health Well Done. In her session on “Building A Successful Imaging Project with Patient Care in Mind”, Dolan-Schweitzer concluded that healthy patients, healthy teams, and healthy projects are the key to operational success. Creating a vision and scope for projects along with utilizing the right team members, establishing rules around communication and reporting, as well as implementing tasks and closing out sign-offs are key to demonstrating returns on team involvement.

“What is important for radiology imaging leaders is to focus on new opportunities for volume and growth due to diminishing returns on traditional methods,” said Lea Halim, a senior consultant for the Advisory Group in her “2016 Imaging Update.” With a market focus on high quality, cost efficient care, and leveraging service advantages, Halim said: “Imaging needs to grow in a principled way.” Key areas for growth include screening, such as lung cancer and CT colonography, developing new partnerships with local employers, and recognizing the ever-expanding service line of interventional radiology that reaches beyond procedural care.

Convenience, options for every level of spend, and transparency are all characteristics that made Uber a consumer success.

“Consumers tell us they want the same things from their imaging services. We have to deliver on all fronts,” Halim said.