In the current climate of accountability, regulation, and continual improvement, radiology managers and administrators are called upon to make timely and informed decisions that affect the quality of their departments’ output (the radiology report) and the financial viability of their practices. Successful managers need a system of measurements (metrics) to reflect the performance of their units in order to achieve strategic goals. In a radiology department, this translates to the manager’s need for access to live data demonstrating workflow and identifying bottlenecks, in addition to the need for on-demand fiscal reports.
The time it takes to build a report using traditional methods reduces both the value of the information and the time that an organization then has available to take action to correct a deficiency. The traditional report can only answer questions that are identified prior to a periodic meeting, and there is no way to answer questions that might occur during the meeting. Without reports based on accurate, current, integrated data, decisions might not be based on an accurate picture of workflow and resource utilization.
For example, the chief technologist might be requesting additional manpower, but without information on how the current workforce is being used, a decision might be based on anecdotal evidence. Perhaps the number of studies performed by the department might be increasing, but reimbursement is decreasing, and the manager needs to identify the reasons for the discrepancy.
During a meeting, a question might come up regarding the utilization of a modality such as MRI, and if this question was not anticipated, a report might not be available. With on-demand reports generated by business-intelligence analytics, a report can be generated in real time.
Business intelligence is loosely defined as using computer techniques and databases to identify and organize information about business processes and trends. Other terms are used in the radiology literature to define the process; these include data mining, data analytics, and using a digital dashboard. Typically, a digital dashboard refers to real-time measurements resembling the dashboard in a car that gives the driver indications of compliance (speedometer) and resource utilization (fuel, oil, and air in the tires), along with warnings of potential problems.
Other business-intelligence analytics can provide static reports on the day-to-day operation of the department. The difference between these business-intelligence analytics and typical reports generated by various information systems is that business intelligence uses data from multiple sources and can generate these reports on demand. Business-intelligence tools and dashboards are described in detail in the literature or in presentations at meetings, but there is very little guidance for the manager who wants to use these tools.
Identifying the Target
Before setting out to find an individual solution for a business unit, the manager needs to define the problems that he or she wishes to investigate. A team approach will help identify specific targets for improvement.
Digital dashboards or business-intelligence tools in the radiology literature usually focus on one or more of these general topics: resource utilization, workflow improvement, improvement in reporting, reimbursement, and quality assurance (to include safety). Resource-utilization analytics provide reports on the productivity of staff and the utilization of imaging modalities.
Workflow dashboards can give the user a real-time display of the flow of patients and procedures through the department. Radiology-interpretation dashboards tend to focus on real-time views of report-turnaround times, and reimbursement models focus on the appropriateness of studies. Ensuring the appropriateness of performed procedures can lead to improvement in reimbursement.
Quality-assurance analytics are used to evaluate errors and to monitor safety measures. For example, two of the Agency for Healthcare Research and Quality’s metrics deal with reducing radiation exposure, and the agency recommends recording CT dose and documenting fluoroscopic examinations’ duration. 1,2 Although tools to measure and monitor radiation exposure are not yet widely available, these quality measures will become mandatory.
Unfortunately, digital dashboards and other business-intelligence tools are not yet widely used, partly because radiology data are