The number-one reason cited by its radiologists for choosing a non-traditional practice setting is to align with a leading organization, according to a survey of its physicians by Radisphere, Westport, Connecticut. Running a close second and third were lifestyle/schedule flexibility and the backing of a professional support team, the poll reveals. The ultimate indicator of practice satisfaction is the number of radiologists who would recommend the practice to others: 92% of the radiologists surveyed say that they would refer a colleague to work for Radisphere, a hybrid practice model based on remote reading and on-site radiologists. Radisphere radiologists anonymously took the online questionnaire in July as part of an ongoing effort to gauge staff satisfaction with the company in general and with various elements of its radiology service model, in particular. Responses were fielded from 59 radiologists, a sample of respectable size in terms both of geography (survey participants were based in hospitals and remote locations throughout the United States) and of subspecialization or fellowship, such as emergency/body, musculoskeletal or neyrolofical. Nearly half (44%) had been employed for four or more years by the company. ImagingBiz obtained an exclusive preview of the survey's results, which highlight many of the key trends that are changing the nature of radiology practice in this country. In this time of uncertainty, fueled by health care reform, the economic downturn, and growing hospital clout, it is not surprising that the top reason given to explain why radiologists signed on with Radisphere is to belong to a leading organization. The second-ranked reason is that Radisphere does a great job of accommodating radiologists' lifestyle needs and providing geographical flexibility. “Our remote radiologists reside across the United States, so there aren’t any geographic restrictions as to where you need to live,” said Radisphere's chairman of radiology, Peter Franklin, MD. “Our hospital-based radiologists are supported by our remote network so weekends and after-hours services are automatically covered.” Gaining access to a professional support team is the third reason for joining Radisphere cited by the respondents. Franklin notes that it is somewhat unusual to find a group—even a large one—with a well-rounded staff of aides. “At other practices, depending on the size of the group, radiologists might have one, two, or maybe three people to assist with billing, but that’s about the extent of it,” he says. “Radiologists, for the most part, are on their own with regard to many nonclinical support activities, such as credentialing/licensing, technologist support, client-service representation, and IT troubleshooting during off hours. At Radisphere, we provide all of that support to our radiologists, so they don’t have these administrative burdens.” Transformational Trends The survey also serves to underscore many of the transformational trends in radiology practice today. For instance, the use of imaging informatics by practices is a growing trend, both to improve workflow and to make growth possible; as practices expand their footprints, their IT budgets also typically increase. When asked about the ability of Radisphere technologies to enhance practice patterns, 80% agree that Radisphere’s information technologies enable them to be more productive, thereby facilitating delivery of results to clients in a more-timely manner. Franklin explains that the key IT tool that the company uses is a leading-edge application, developed by Radisphere, known as radii_TM. “It provides levels of functionality that no off-the-shelf RIS or PACS can offer,” he says. “radii provides the ability for all Radisphere radiologists, on-site and remote, to share applications which is unique to radiology practice. “In many traditional groups, radiology systems are difficult to use, not intuitive and actually slow down the radiologist," he continues. "Our systems, however, were custom built and adhere to HL7, DICOM, and other industry standards that simplify and enhance the ability of radiologists to do their work. Based on our survey findings, it’s clear we’ve made significant strides in providing our radiologists with tools that allow them to be more productive and systems that they feel very comfortable using.” Improving the Product Unclear radiology reports have been the subject of frequent complaints by referring physicians. A total of 82% of Radisphere radiologists indicated that the organization’s proprietary information technologies enable them to prepare reports that are superior in accuracy and overall quality to those generated by the radiology practices with which the respondents were previously associated. A key tool that supports the delivery of clear and consistent reports is Radisphere Lexicons, explains Franklin. “Lexicons serve as a checklist for radiologists and will not allow dissemination of a report until the radiologist assigned to the case completes all of the listed steps. If you’re viewing a case, Lexicons automatically takes you through the entire scope of pathology necessary for that specific study,” he says. “It allows no aspect of the study to be skipped or overlooked. This affords a tremendous benefit to the client because, no matter who reads the study, the delivered report will be consistent in what’s covered, how it’s stated, and how it’s presented. Also, Lexicons is best-practice methodology for ensuring that all images and structures are subjected to systematic inspection, and that an obvious pathology does not distract the radiologist from discovering a subtle or unexpected finding.” Franklin adds, “Because of Lexicons, we can make certain that each radiologist who reads a study then prepares a report using consistent verbiage. As a result, clients encounter no variability in our reporting style or quality.” Based on the survey responses, Radisphere’s radiologists agree; 82% of respondents concurred that it is an important aid to ensuring improved quality of reports. A further benefit of the tool is improved workflow: 75% say that Radisphere Lexicons helped them experience improved productivity. Peer Review with a Purpose Quality is of growing importance in health care, and peer review is one of the key clinical indicators of quality in radiology. In support of this, 90% of the respondents affirm that Radisphere’s peer-review process is helpful, and 80% agreed that it is among the most effective practice peer-review processes with which they are familiar. “There aren’t many traditional groups that do this, but our standard procedure is to have a certain percentage of interpretations reviewed by a second radiologist in double-blind fashion, meaning the reviewing radiologist is not apprised of the original interpretation results nor of the identity of the original reading radiologist,” Franklin says. “In addition, it is not even known to the reviewer that the study has already been read by another radiologist.” He stresses that the peer-review findings are used for radiologist education and development, not for disciplinary purposes. Collegiality was another key indicator of staff satisfaction: 88% say that they found it valuable to be able to consult with other Radisphere radiologists. “Consulting on difficult cases with peers who are experts in their specialty yields accurate reports and shared best-practices, but it also fosters a team atmosphere,” Franklin shares. “In traditional groups, depending on their size, the radiologist may not have access to subspecialty radiologists for consultations and support.” Among Radisphere radiologists hired within the past year, each one says that the new-employee orientation that he or she received was advantageous. “We’re very focused on helping our new radiologists integrate as swiftly and smoothly as possible,” Franklin says. Refer a Friend Radisphere leadership is most proud of the finding that 92% of respondents say that they would recommend the company to colleagues known to be thinking about joining a radiology group. Key reasons that the respondents cite for recommending Radisphere to colleagues were its status as a stable and secure radiology practice, little or no intrusion of office politics, fewer administrative duties imposed upon radiologists, the availability of malpractice coverage, and minimal on-call and weekend-coverage demands. “Our survey validates that those who have joined us are comfortable and well-satisfied working in this organization and in this type of model,” Franklin says. “It shows that our approach to the delivery of radiology interpretations is clearly a viable option, and suggests that it pays to structure a large group in a way that allows radiologists to thrive in their work, and to be comfortable, confident, and satisfied using the tools and systems provided for them.”Rich Smith is a contributing writer for ImagingBiz.com.