JACR: Outsourcing radiology could spell chaos

A single, cohesive, on-site radiology group does a better job of adding value to a hospital than when radiology responsibilities are taken over by other specialists or remote teleradiology companies, according to an article in the September issue of the Journal of the American College of Radiology.

Hospitals benefit from a dedicated radiology group in six different areas, and if they allow their radiology departments to be fragmented, “most of these added values would be lost, and chaos could ensue,” wrote Vijay M. Rao, MD, and David C. Levin, MD, of the Center for Research on Utilization of Imaging Services at Thomas Jefferson University Hospital in Philadelphia.

According to Rao and Levin, the six areas where hospital-based radiology groups add value are:

• patient safety;

• quality of the images;
• quality of the interpretations;
• service to patients and referring physicians;
• cost containment; and
• helping build the hospital’s business.

Rao and Levin listed numerous reasons for the superiority of hospital-based groups, but many revolve around the notion that a hospital-based radiology group will have expertise and dedication to medical imaging that other specialists may not.

For instance, radiology is rife with potential patient safety risks, such as exposure to radiation or strong magnetic fields. Physicians without the same level of training as radiologists may put patients at risk or may be too focused on their primary specialty to provide proper oversight.

Radiologists also will be able to interpret an entire image, rather than a single organ or region, while a nonradiologist physician will most likely only have expertise in one area.

“If physicians from several different specialties are performing these cases, chaos and delays would result,” wrote the authors. “Each time one case ended, the technologists would have to scramble to locate the next specialist who was scheduled and hope that specialist was not tied up in the office or somewhere else in the hospital.”

Without this potential confusion, Rao and Levin said a dedicated radiology group will be able to lower costs and minimize turnaround time. In addition, a hospital-based group will be motivated to be more financially conscious and devoted to growing the hospital’s business, as opposed to a teleradiology firm focused on per-click reimbursement.

Because imaging is a major revenue source, often one of the largest contributing factors to a hospital’s bottom line, having a hospital-based radiology group is an important part of adding value and growing business, according to the authors.

Rao and Levin cautioned radiologists not to succumb to apathy or complacency. They believe a hospital-based radiology group is the best way to provide these value-added services, but hospital administrators must be educated on the merits of such a system. They cited a previous article in the Journal of the American College of Radiology in which the authors said a growing number of radiologists are not taking an active role in implementing these services.

“If that continues, the future outlook for radiologists will be seriously jeopardized,” wrote the authors. “To ensure our places in our hospital practices and the healthcare system at large, all of us in the field must see to it that providing true added value is a reality, not just a buzzword.”