AHRA: The imaging strategic plangetting it right
DALLAS—Although a lack of strategy can lead to failure, it’s possible for organizations to fail despite good strategies, said Brian Baker, president of Regents Health Resources, during an Aug. 15 educational session at the AHRA annual meeting.

Strategic planning provides an essential opportunity to view the enterprise through an analytical lens and consider the future to improve current operations and systems to offset what might happen in the future. It’s often intimidating, and may seem overwhelming, said Baker.

Yet, Intermountain Healthcare in Salt Lake City, which comprises 23 hospitals, 160 healthcare facilities and 32,000 employees, completed a comprehensive strategic plan in less than five months with the aid of Regents Health, a consulting firm based in Franklin, Tenn.

Despite Intermountain’s national recognition in being a healthcare provider, it was not running imaging like a business, said Deanna Welch, system director of imaging services at Intermountain. Imaging departments were not paying attention to referring physicians, and patient management was casual, said Welch. The mindset was that the organization did not need marketing.

At the end of 2008, COO Joe Horton launched a new organizational imperative to manage imaging services and determined that imaging required organization-wide standards. Intermountain engaged Regents Health to help facilitate the process.

The extensive project analyzed 2.7 million data lines, entailed 500 interviews and surveys, required 2,048 man hours and shadowed patients. Although Intermountain maintains a robust data warehouse, pulling out the data and making it useful was a challenge, said Baker.

The data challenge, said Baker, pervades healthcare. “We find hospital clients have a hard time getting their hands on data and measuring it. But without data it’s very difficult to predict how to respond to the challenges of healthcare reform.”

The data brought a few surprises to Intermountain. The enterprise found it had more competition than it thought and realized its market share wasn’t quite as high as expected.

The answer to the specific needs and identified in the analysis was a 14-point plan, which included the following strategies:
  • Centralized scheduling and pre-registration;
  • Automated online scheduling and pre-registration;
  • Regionalized marketing programs;
  • Outpatient imaging services, as the system’s offerings were primarily hospital-based;
  • Development and communication of competitive pricing;
  • System-wide equipment planning and purchasing;
  • Equipment service protocols to lower capital and service costs and reduce variability;
  • System-wide performance and financial standards;
  • Standardized department and radiologist workflow;
  • Uniform data reporting, mining and dashboards;
  • Aligned incentives and accountability between radiologists and the healthcare system;
  • Revised organizational structure and accountability, including a governance component charged with decision-making authority; and
  • Pre-authorization and clinical decision support.
“We learned there is room for improvement at even the most-decorated organizations,” summed Welch.

She concluded by sharing key lessons: marketing needs to be prioritized, customer service needs improvement, physician alignment in clinical and business areas needs focus and disparity in operating standards is prevalent. Despite the challenge, it’s possible to manage imaging as a business and not just a service line, said Welch.