The advent of teleradiology has changed the way radiology is practiced, disrupting the exclusive business arrangements between hospitals and their radiology groups and opening the market to competition. A new consulting firm called Accountable Radiology Advisors (ARA) hopes to help groups make the transition to the new reality.
ARA was established in April by Teri Yates and colleagues Dawn Harris-McClain and Kimberly Luse; Yates has previously served as chief quality and risk officer at Radisphere National Radiology Group and as vice president of sales and marketing at ProScan Imaging.
"We want hospitals and their radiology groups to become more competitive, reduce their liability risk, and succeed together," Yates told AuntMinnie.com.
Teri Yates from Accountable Radiology Advisors.ARA works with clients to identify weaknesses in the quality and safety of the radiology service they provide -- and this is one of the factors that sets it apart, according to Yates.
"There are lots of healthcare consultants out there and a number who consult in radiology, but mostly around workflow or technology issues," she said. "We don't know of other radiology consultants who focus on the quality piece of the picture."
Radiology groups have always viewed their hospital's needs through a service lens, and most do a good job providing that service. But because it has traditionally been difficult for hospitals to change radiology groups, some practices have gotten complacent, according to Yates. The emergence of national radiology groups upset the status quo and sparked dialogue about quality in radiology.
"The disruptive nature of these groups is stimulating change, and talking about quality in radiology is good for patients," she said. "The reality is, if radiology groups don't meet the legitimate needs of their hospitals, they're setting themselves up to be eliminated."
Changing culture
There's no doubt about it: The culture of radiology has changed, Yates said.
"Radiologists have enjoyed a lot of autonomy over the years, practicing as a contracted service," she said. "But this has also left them out of key conversations and has discouraged teamwork. The best radiologists need to see themselves as consultants -- to involve themselves in the whole process of patient care -- consulting with referring physicians even before the exam is performed to determine what clinical question the exam is trying to answer."
Hospitals and radiology practices are not fundamentally at odds. But hospitals must hold their contractors accountable for providing good service, putting service terms into the contract and demonstrating that those terms have been met, according to Yates.
"We want to help hospitals and radiology groups grow sustainable volume, while also carefully examining and controlling imaging utilization," she said.
And since ARA helps its clients become more accountable for the service they provide, it has built accountability into its own business model, Yates said.
"We're trying to work with our clients to focus on accountability, and in order to be successful in doing that, we have to focus on accountability in our service," she said. "So we include pay-for-performance terms in our own contracts. After all, what's a common complaint about consultants? That they're expensive and don't produce results. We're going to change that."
Most radiology groups are small, with fewer than 10 members, and can't necessarily afford to put a quality guru on the payroll -- which is where ARA steps in.
"We want to offer virtual quality director service to smaller groups, help them understand best practices for improving quality, and serve as their representative," she said. "So many small radiology groups thought they'd be in contract with their hospital forever but find themselves replaced by larger groups. They need to find ways to be more engaged."
