Improving Workflow in Free-Standing Imaging Centers

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There are many levels of workflow in free-standing imaging centers - all focused on maximizing time for patients and referring physicians. They all share the Holy Grail of perfecting efficiency to ensure monetary success. And proactive campaigns that constantly examine and perfect every step of the workflow - from the time the appointment is scheduled to the time the report reaches the referring physician - are the best way to secure success.

Imaging equipment is a huge capital expenditure for any healthcare provider, whether it's a large medical center, mid-sized hospital or free-standing imaging center. For the latter, the only imaging assets that make sense are those that enable the center to maximize patient volume and streamline operations and workflow. At the same time, managing this volume requires a level of operations and workflow that runs at optimal speed - timely scheduling of exams, quick patient throughput and fast report turnaround time.

"There are really three [components] to workflow," says Shane Forman, president of 3d Health Inc. in Chicago, a business advisory company to radiology groups, imaging centers, hospitals, and multi-specialty group practices. "First, there is workflow within the center, which is the efficiency of moving patients through. Second, there is customer service-related workflow, and that is workflow surrounding the patient experience and making sure that you maximize that patient experience. Finally, there is a whole separate workflow that is about maximizing the referring physician experience."

In terms of in-house workflow, Forman explains that there needs to be an understanding of how much time each exam takes as to not create a backlog. This will directly impact how long patients wait from the time they enter the building to the time the exam is actually performed by the technologist. In terms of increasing patient experience, "this really starts when the patient calls to book the appointment," poses Foreman. "Everything that the center does should revolve around the patient experience, such as appointments, parking and the check-in process. We are starting to see some centers begin to offer patients multiple ways to fill out paperwork, such as online, fax or email [forms]."

The final component to Foreman's model is maximizing referring patient workflow. "To compete in most markets, you need to offer same day/next day scheduling and two-hour stat reads for referring physicians and results within 24-hours."

According to Dave Frazee, president of Frazee Nuclear in Cleveland, Ohio, a nuclear medicine/PET consulting group that conducts productivity operations reviews, if there is a backlog and the physician cannot schedule an appointment, he or she will stop using the facility. Expectations are usually met if the facility can get a patient scheduled within five to seven days. "After the referring physician calls a number of times and it's always a two-week backlog, that physician will stop calling your facility and send patients else where," challenges Frazee. "And it's often the case that the facility does not know about the problem because they don't have good communication with the referring physician."

Improving the backlog requires looking at a couple years worth of data. "We look for problems in scheduling that may only be seasonal or chronic," poses Frazee. "If it is chronic, then why? Sometimes it may be a staff shortage or they need to add another piece of equipment to facilitate or reduce the backlog of wait time for scheduling." Frazee also recommends sending out surveys to both the referring physicians and their office staff to learn more about the severity of the backlog.


Staff and physicians in imaging centers must work together and hit all the right notes to ensure referring physicians get the report with the diagnosis. Digital dictation, voice recognition systems, data and image management systems and information systems all help to improve workflow and consolidate volume. Implementing newer technologies requires strategic planning and team involvement to develop training programs, set goals and realize exactly how the new equipment will impact every facet of the facility.

"You will obtain 30 to 40 percent efficiency in terms of personnel with picture archiving and communications systems and radiology information systems," says Jeff Landman, MD, partner of New Light Imaging, the management company for Cools Spring Imaging in Franklin, Tenn.,