The Essentials: Information Technology for the Practice

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ARA.jpg - Austin Radiological Association
Austin Radiological Association (ARA) maintains a large IT staff of 40 full-time equivalents that work in four groups: data center operations, desktop and clinical user support, software development and applications management.

Radiology is an IT-intensive specialty, one that mandates an investment in information technology (IT)—and continuous updates— that is substantially greater than other medical specialties. Radiology Business Journal talked with the IT leaders of five Radiology 100 practices to learn about the requirements to support a practice’s clinical, administrative and communications needs.

Our sources agreed that every practice requires the following four IT essentials: a robust, secure infrastructure that allows for rapid response to meet changing business needs; a well-designed system that has multiple layers of redundancy and security; software that accommodates the radiology practice both clinically and operationally; and a competent IT staff.

In addition, it is important that IT recognizes that it represents a service to the professional radiology company. IT priorities and goals should be focused on supporting the core business of professional radiology and how the IT department can bring value to a practice’s overall strategies and goals. 

As a result, IT directors must keep close tabs on the continually changing healthcare regulatory environment, as well as more typical IT concerns of security and hardware and software developments. They need to be able to analyze the many different types of workflows in a practice, and to identify technology that can improve them.

Articulating IT’s value

Nonetheless, it is incumbent upon IT to articulate the importance of strategies that may not be well understood by practice leadership. “The IT team has an obligation to demonstrate to practice leadership how the IT strategies and proposed expenditures support practice goals and thus why they should adequately fund the strategies we recommend,” Ron Mitchell, CIO, Wake Radiology, Raleigh, N.C., notes. “For example, maintaining tight security represents a large annual investment that does not show any financial return. It is a continuous challenge for us and we are constantly developing defenses.”

Joe Moore of Radiology Consultants of Iowa (RCI), Cedar Rapids,  concurs that IT must lead and educate on security matters, in addition to determining what types of technology need to be implemented and used to promote business functions. Moore is supported by tech-savvy entrepreneurial physicians, four of whom are members of the practice’s IT Committee.

“They like to be part of the design and execution of new, innovative tools that help them practice and make radiology more relevant to referring physicians,” Moore says. “They roll their sleeves up with us and champion each new change, making it much more successfully adopted by the rest of the radiologists.”

At Austin Radiological Association (ARA), priorities and projects identified by IT are presented during the budget cycle for funding and approval. That doesn’t mean there won’t be change throughout the course of the year, CIO Todd Thomas says.

“When our radiologists or clinical operations staff make a decision to adopt a new technology—such as digital breast tomosynthesis—we do what is necessary to accommodate it,” he explains. Thomas’ team needs to be ready to manage the transfer and storage of the huge quantities of data that this new technology will generate.

Nanette LaRosee, IT administrator, Rhode Island Medical Imaging (RIMI), East Providence, also acknowledges the need for IT to be flexible and nimble to accommodate priorities that change at a moment’s notice. If resources are not immediately available to accommodate all needs, she recommends prioritizing projects based on patient-care improvements.

Staffing considerations

There is no rule of thumb for sizing a radiology practice’s IT department, and indeed it varied from a staff of 40 at ARA to five at Advanced Medical Imaging Consultants (AMIC), Fort Collins, Colo. At AMIC, being able to cross-cover the work of a colleague is a necessity, CIO Lawrence Long reports.

The 56-radiologist RIMI has a small IT department (7 FTEs) in relation to the size of the business. In addition to the director, there is a software/analytics team (3) and a networking/infrastructure/communications team (3). The PACS administrator oversees all infrastructure/connectivity as well as the PACS. He also manages a data center/telecommunications specialist and a PC technician/web administrator. All team members have hybrid roles and work closely together. LaRosee said that the department has utilized consultative services in the areas of network security, storage