It was a gutsy move even by the standards of the borough that is home to the New York Yankees, the birthplace of hip-hop, and the largest zoo in the East: At just 23 years old, with no direct experience in healthcare, Joel Reisman decided to dive into the deep end of the outpatient medical imaging business in the Bronx.

The spark came in the form of a tip from a friend. The friend worked in medical billing and had heard about a single-site imaging operation that was financially troubled and looking for a buyer. He also knew of Reisman’s entrepreneurial aspirations.

 Reisman took the advice, and the deal went down without a major hitch. The acquisition included an aging MRI scanner and other starter equipment. Six months later, satisfied that he was adequately trained and the business sufficiently established, Reisman replaced the old equipment with new. At that point, he found himself setting the pace rather than running to keep up.

That was about a decade ago. Today, Distinguished Diagnostic Imaging (DDI) is a growing, four-site enterprise with 30 employees. Five radiologists provide reading services.

Two more sites and a number of new staffers will come on line this year—along with an expanded coverage pool that will include several more general and subspecialty radiologists. In 2017, Reisman plans to add three more sites—and all the manpower and technology it takes to run them in state-of-the-art form—by building and/or buying.

“My philosophy is to stay in one borough and cover the entire borough from A to Z with a single call center, which we already have,” Reisman explains.

More partner than vendor 

Given the inspiring background and ambitious aims, one could say that DDI is setting the pace and looks to continue doing so for years to come. A common thread—Viztek Healthcare IT, now a part of Konica Minolta—connects DDI’s past successes, present productivity and future plans.

“Around the end of 2004, while I was busy setting up the new operation, I learned about the Viztek PACS,” Reisman recalls. “At that time the big advantage was the ability to send images through DICOM to a radiologist who could read the cases without coming to our site.” 

The next year, DDI became one of the first outpatient radiology centers in the Bronx—if not the very first—to have a PACS, Reisman says. He adds that Viztek RIS solutions have proven equally instrumental in propelling his growth trajectory through the past decade.

“I started with the Onyx and then, when Viztek came out with Opal, I became a beta site for that,” he says. “Viztek had quite a few people come through our facility to see how the system worked and its advantages.”

Enter Exa

Ready again for the next-generation technology, Reisman recently researched available options before deciding to stick with Viztek for his latest upgrade: DDI is now gearing up to implement Exa Platform, the latest Viztek technology, which is an IT platform versus just a PACS, and features server-side rendering, performance dashboards, specialized viewing tools, a zero-footprint viewer, portals for both patients and referring physicians, custom workflow design, and a dictation-integration module.

Asked what made Exa stand out from the competition, Reisman replies: “When it comes to technology, especially software, everything is so customized that there are always issues. It always takes time until things are adjusted in a way to support optimal flow. With Viztek, if you have any problems, they have people to walk you through.”

He compares this approach with what he experienced with another vendor, a leading OEM that, he says, “patched together” a critical software solution from existing systems it had acquired piecemeal.

By comparison, he says, Viztek expertly engineered the Exa Platform from scratch and  “maintains their personal touch. You can direct your question to the right person right away. They turn their attention to your need with no delay.”

High-tech touchpoints  

Drilling down to the point-of-use technological pluses that distinguished Exa PACS, Reisman zeroes in on its capacity to provide a single database for all patient data—not just images and reports but also scheduling and billing.

“Before, you would have the RIS and the PACS interfacing through HL-7, and you were working with different interfaces altogether,” he explains. “You get a lot of glitches when you work with two different databases.”

He offers the example of a patient who is checked in for an MRI of the brain and, at the time of the scan, the technologist realizes that the order included contrast. Making that adjustment at that point would involve changing the accession number, creating a conflict between the RIS and the PACS.

“A lot of things like this can happen when you are working with two separate databases,” says Reisman. “And the biggest effect can be on billing, where maybe the front desk doesn’t have the correct balance owed when the patient arrives. With the Exa, everything works on one database.”

Virtually everyone in DDI’s orbit of activity will benefit, he says.

“Every radiologist will be able to see, much more quickly, all of the notes in the histories of the patients,” he says. Speaking of speed, the zero-footprint viewer, combined with server-side rendering, provides enhanced radiologist workflow for huge CT and MRI studies that incorporate thousands of slices.

Referring physicians will appreciate that Exa is compatible with all major operating systems and platforms, including iOS, Windows, and mobile, he says. Reisman says this will help streamline DDI’s “entire environment” for all parties within and without, from scheduling and billing staff, to customers and payers, to radiologists and their all-important referrers.

Tools to build the business

Other benefits Reisman is excited to tap into with Exa include:

• Digital breast tomosynthesis support. “We are going to be the first outpatient site in the Bronx to offer tomosynthesis,” he says. DDI’s tomosynthesis vendor offered an option to buy the workstation, so he did some comparative research on the workstation versus the Exa tomo application. “I got great feedback from my breast-specialist radiologist,” Reisman says. “I was very comfortable going with the Viztek Exa PACS to support our tomo program.”
• Portals for patients and referring physicians. “Just look at people walking around with their mobile devices,” Reisman observes. “We have been getting asked by patients a lot lately why they can’t sign in and do all the administrative stuff electronically. Now, they will be able to.” Nor will referring physicians have to call to book an appointment for a patient sitting in their office with a palpable lump. They will be able to find the next availability from the Exa referring physician portal and book the appointment electronically.

Reisman says demand continues to grow for diagnostic imaging services in his market. He projects that DDI will perform more than 100,000 exams this year.

“There are a lot of physicians who have more than one office,” he says. “When you are servicing them at one imaging site, they will automatically send you patients from their other office as long as you have an imaging center near them.”

“It’s been working,” he adds, referring to what may truly be the boldest outpatient-imaging growth plan in the Bronx. “Every time we add another location, I get more referring physicians, and I get busier. With the Exa Platform, working with one system with one database is going to make my life much easier.”

With the acquisition of Viztek, Konica Minolta has established their global Healthcare IT (HCIT) headquarters in Raleigh, NC, where the Exa Platform was engineered.