Practice Management

I've seen this a few times.  It can be done.

However,

The larger issue is making sure all Group leadership really debates this one.  It has been a divisive discussion for many years.

Tracking phone calls, interruptions from staff, and referring physicians is a consideration.  Are these tasks valued and tracked?  Also, is administrative time for leadership positioned being tracked as the Group leaders are handling emails and calls from hospital and practice administration?  Consider any meetings or committee assignments during the day.

Some of the RVUs often cause modality debates.  By this I mean, one specialist might argue that another modality or exam has an RVU value that doesn't appear to represent the work compared to something else within the Group.  So just because Medicare has assigned an RVU, doesn't mean the members of your Group will agree.  So you have that issue to debate as well.

Some Groups have discussed the issue at length and have chosen a path of trust, value, and respect rather than using the RVU productivity model daily.

I hope this helps.  I know the issue, and finding balance internally for all Group members has been a challenge for quite a while.

I also recognize that some Groups may have a different opinion and have addressed it in their own way.  So, these are just my thoughts on the issue.

Thank you for the suggestions.

Barry, we have debated this for years as well.  We are not productivity based and I've been opposed to it for years.  I feel that we're better off to have a good, solid group who works together than to create an incentive plan because of an outlier or two.  There was a time when you could replace someone who didn't share a similar work ethic as the rest of the group.  The radiology crisis in staffing has created many challenges.

Some of our rads have asked for a tracker so they can gauge how they're doing in a day.  Your response reminds me that even this may cause rifts in an otherwise cohesive group.

I'm curious how many hospital based, small private practices have moved to an RVU based incentive plan.  I'm sure the forum would love your feedback if you have any.

Thanks!

Linda

I agree.

We do use it and we use a data company and software to interface it with QGenda / RIS / billing / PACS / and VR products so we can review by chair assignment.

We also will consider volumes and payments during the review.

We don't use it daily, though.  We use it quarterly and annually to make adjustments in radiologist staffing levels and chair assignments.

Enjoy your weekend!  See you at the RBMA!

Linda,

We met a vendor at our local RBMA chapter meeting that does this.  His company name is FINAO. Maybe they could assist.

Thanks,

Mindy

Hi all,

I have been in radiology IT for 25 years and measuring productivity has been something I have put in a place a couple of times.  I am the CIO of Wake Radiology and we are using Clario, a unified worklist to do this, but I doubt you want to put in a worklist just to get an RVU gauge.  I know that Primordial had the ability to do this and since it was very modular you might want to talk to Nuance and see if they have a module you could use.  Quantum imaging built a product calledPACE that might work for you.  They sell it under the Q-IT brand https://q-itsolutions.com/.  It is based off the GE worklist, but in my talks with them it might be adapted to work off other things.  RadAI recently acquired a company Equium Intelligence https://www.equium.io/ that is really meant for efficient scheduling of radiologists, but one of the ways it does it is to figure out the complexity of cases and estimate time taken to read.  They might have a widget that would tell you estimated and actual rvu.

I am currently working on a doctorate in healthcare administration, and I plan on doing my dissertation around this topic.  According to some papers non countable time (non RVU time) can account for more than 32% of the time in private practice and almost 52% in academic practice.(Brady, 2011)  Another study said only 37% of a radiologists time was spent actually looking at images.(Dhanoa et al., 2013)

An application was developed at MCSU to capture non RVU tasks(Kovacs et al., 2018), and Clario also has this ability.

What I am hoping to do is build an algorithm that is better than RVUs, that could be used by the industry.  RVUs don't take into account complexity of cases such as if an exam is an ER exam which is most often negative or a cancer case where there are lots of measurements to be done on the case, or just comorbidities in general. In Australia they have started to do research on using study ascribable time instead of RVUs.(Pitman et al., 2018)  If you are interested in this and would like to help please let me know.

Thanks,

Matt

Brady, A. P. (2011). Measuring radiologist workload: how to do it, and why it matters. Eur Radiol, 21(11), 2315-2317. https://doi.org/10.1007/s00330-011-2195-2

Dhanoa, D. B. M. D. M. B. A., Dhesi, T. S. B., Burton, K. R. M. M. B. A. M. D., Nicolaou, S. M. D., & Liang, T. B. (2013). The Evolving Role of the Radiologist: The Vancouver Workload Utilization Evaluation Study. Journal of the American College of Radiology, 10(10), 764-769. https://doi.org/10.1016/j.jacr.2013.04.001

Kovacs, M. D., Sheafor, D. H., Thacker, P. G., Hardie, A. D., & Costello, P. (2018). Metrix Matrix: A Cloud-Based System for Tracking Non-Relative Value Unit Value-Added Work Metrics. J Am Coll Radiol, 15(3 Pt A), 415-421. https://doi.org/10.1016/j.jacr.2017.10.028

Pitman, A., Cowan, I. A., Floyd, R. A., & Munro, P. L. (2018). Measuring radiologist workload: Progressing from RVUs to study ascribable times. J Med Imaging Radiat Oncol, 62(5), 605-618. https://doi.org/10.1111/1754-9485.12778