The Metamorphosis of a Practice

View Dr. Cury's Radiology Leadership Institute™ presentation.

It is a conundrum most radiologists face at some point in their careers: how to stay true to the needs of their patients while consistently meeting business goals for their practices. As the health care industry moves toward an emphasis on value over volume, some facilities are recognizing both challenges and opportunities as they turn to a more service-oriented business model. The benefits of strategic planning have now become paramount as radiology practices begin to change how they respond to the multifaceted needs of their patients in a more efficient and effective manner.

Ricardo C. Cury, MD, president and CEO of Radiology Associates of South Florida (RASF) and director of Cardiac Imaging, Baptist Hospital of Miami and Baptist Cardiac and Vascular Institute, has been a leading force for helping practices transition from the traditional, fee-for-service model to one where success is measured in terms of high quality patient care. While discussing how he has used methods of strategic planning successfully for his own practice, he guides others on what they can do to build on their current strengths and form their own future strategic plans. He feels the present changes in the health care industry should encourage radiologists to take time to fully assess what they want to achieve for their practices in the new era of Imaging 3.0™.

“The focus in the past has been on productivity and efficiency,” says Cury. “While part of that will remain, radiologists also need to focus on the quality of care and service level they are providing to patients and referring physicians. Specifically, radiologists should become consultants with the ability to develop clinical pathways based on Appropriateness Criteria^® for imaging with the goal to enhance coordination of care.”

Formulating a Strategy

To kick off his practice’s transformation process, Cury’s team began by holding annual strategic planning sessions. These planning sessions helped Cury’s team agree on a mission statement, prioritize goals for the practice, establish context for the strategy by examining internal and external issues, and evaluate their strengths, weaknesses, opportunities, and threats (also known as a SWOT analysis) to the practice in light of those issues.

See an example of SWOT analysis 

Cury suggests that a critical first step in the strategic planning process is to develop a formal mission statement — including specifying the practice’s mission, vision, and core values. Next, it is time to define specific goals and objectives — including identifying actual timelines for achieving those goals — in order to align all members of your organization with a common and shared direction. Equally important, the practice leadership needs to be accountable for executing the plan and achieving the established goals. In that context, it is imperative to establish metrics by which your organization can measure its progress.

 

For Cury’s practice, one of the most important goals within the strategic planning process involved strengthening the radiologist and hospital relationship. “We need to answer how we are adding value to our hospital partner and what activities we are implementing to accomplish those objectives,” states Cury. Other objectives include improving personal service in the delivery of care to patients and referring physicians, investing in IT and marketing initiatives (such as creating an annual report), participating in community events involving breast cancer awareness, and redesigning the practice’s website. For each of their goals, the team developed metrics, and they hired a data analyst to review measurements, oversee reports on subspecialty expertise, and tally surveys on patient and physician satisfaction.

Examining the Issues

For the next phase of the strategic planning cycle, Cury suggests looking at both external and internal issues affecting a radiology practice. For example, this could involve considering how health care reform is impacting new payment models — particularly in the transition of fee-for-service to quality-based payments, such as pay-for-performance, bundled payments, and shared savings. He also recommends observing how other practices are positioning themselves.

See an example of a mission statement.

For internal issues, Cury believes it is crucial to have governance and oversight to create a strategic action plan. Having a small, core group serving on an executive committee, with oversight by a board of directors, creates a sense of support that is vital for implementation. “I think it gets everyone in your practice on board with the same vision,” he states.

Executing the Plan

Cury says that while the strategic planning process is critical, departments should spend the majority of their time on the execution of the plan. According to Cury, increasing the visibility of radiologists is a key factor for success. Being part of hospital committees, establishing clinical pathways that lead to the best imaging test for specific conditions, improving imaging protocols to ensure the quality of images, and having a peer-review process that provides subspecialty expertise can all be part of creating a more visible presence for radiology.

See an example of goals and associated metrics

Cury provides a key example of how his practice is working to improve radiology visibility among its stakeholders, including referring physicians and hospital administrators. RASF implemented an initiative called Radiology Rounds, where radiologists perform rounds with other clinicians on the hospital floor. They currently have two pilot programs operating, one in neuroradiology and one in cardiac imaging.


“The radiologists conducting Radiology Rounds have made a major impact with our referring physicians and the administration by offering just 30 minutes of their time,” he explains. “It has also had an effect on patient care and satisfaction. We review images on an iPad directly with patients. We can see the reaction of patients as they understand how they can change and become more compliant with medications and the modification of risk factors.”