Feature | March 14, 2012 | Jeremy Enfinger

Preparing for Healthcare Reform

A technologist shares thoughts about how radiology departments can get ready for impending changes.

Jeremy Enfinger

Like Californians waiting for the next earthquake, we all know that healthcare reform is coming. Similarly, we do not know exactly when it will arrive, what kind of damage it will cause, how it will affect us in our immediate surroundings or what we can do, specifically, to prepare for its arrival. All we can tell for now is that it will impact us financially with a decrease in Medicare reimbursements — and we can safely assume similar effects with insurance reimbursements.  

In a time when a majority of hospital systems are already in the red and rumors of layoffs fill the halls, we must hastily take steps to prepare our institutions for the impending “shake up.” As a radiologic technologist working in a hospital environment for a number of years, I have several recommendations about what hospitals can do, based on my observations:

• Equipment replacement — If your hospital system has older equipment that needs to be replaced, there are several criteria to consider when deciding which equipment will be replaced and in what order.  

Each piece of equipment has a “lifetime expectancy” assigned by the manufacturer. You should have an inventory of your equipment that includes this statistic. Some equipment can perform well beyond the expected life, but be prepared to spend money when this time approaches, and know whether or not replacement parts are still being made for some of your “dinosaurs.“

You also should perform an analysis of equipment down-time and repair costs. If you have two rooms with 10 years difference between their manufactured dates, but one of the rooms is down 50 percent more often than the other, you may wish to prioritize its replacement.  
Exam volume for each room is another important detail. As Indiana Jones once said, “It’s not the age, it’s the mileage.”  

When it comes to replacing a system, you may want to consider limiting your vendors to two or three choices. You may be tempted to sign a contract with a single vendor for your entire hospital system. But what would keep that vendor from increasing prices down the road if it has a monopoly on your business?

Having more than one supplier keeps prices competitive on equipment and service contract costs. It also gives you negotiating power, due to the high number of purchases that will be made in regards to commission for each piece of equipment.  In addition, it provides flexibility of options for other equipment if the demand for variation of services ever arises.

• Standardize supplies — At the system level, and especially if you have multiple hospital sites, standardize your supplies. Supply chain management should be able to gather information, such as which facilities use different supplies to perform the same job, their cost difference, how much of a surplus each facility ordinarily keeps at hand, as well as how often supplies are disposed of because they expire. If you have 10 different hospital locations using four different types of contrast media to perform intravenous injections, you could save a lot of money by simply deciding on one brand of contrast to use. The seller is more likely to cut you a deal for two reasons: you are ordering in bulk and using them as your exclusive vendor. If they are unwilling to negotiate on these items, move on to the next vendor.

• Staffing — Take a good hard look at staffing. The days of staffing five technologists from 7 a.m. to 3:30 p.m. are over. Examine your patient volume. You may find, for example, that between 7 and 9 a.m. you have an increasing volume, but you are not at the department’s peak capacity until about 10 a.m. You can improve your department’s productivity by staggering start times.  You may find that lunch breaks are easier to acquire by doing this, and you also might be able to perform the day’s tasks with fewer FTEs due to the additional staffing at shift change periods.  

If you have a particular time frame when there are few exams being performed for periods of more than three or four hours, consider an on-call rotation rather than staffing a technologist at all times. Make sure that new hire contracts do not isolate technologists to one particular start time or shift; this needs to be variable.  

Another great staffing idea that works in larger hospital systems is creation of a casual float pool. If you have someone on vacation or if a sick call arrives, you can avoid paying overtime by staffing technologists who can be trained and dispatched to any hospital location within your system.

It is difficult to prepare for the unknown. We are bombarded with opinions from experts with opposing views about how healthcare reform will ultimately affect us all. With the knowledge that we will soon have to do more with fewer resources, it is imperative that we move now, start taking ownership of our financial slack and make progressive changes like those listed above if we are to survive.

Jeremy Enfinger is a lead radiologic technologist for Scripps Health in San Diego, Calif. He also is an adjunct instructor at San Diego Mesa Community College.

Related Content

SIIM Announces Keynote Speakers for Conference on Machine Intelligence in Medical Imaging
News | Artificial Intelligence | September 21, 2017
The Society for Imaging Informatics in Medicine (SIIM) recently announced several corporate and government experts as...
News | Imaging | September 18, 2017
Mary Washington Hospital and Union Health-Union Hospital will both receive Safety FiRsT grants to implement safety...
Understanding True Patient-centered Care in Radiology
Sponsored Content | Whitepapers | Imaging | September 18, 2017
What is the true meaning of “patient-centered care”?
ASRT Donating $10,000 in Support of Hurricane Irma Relief Efforts
News | Business | September 12, 2017
September 12, 2017 — The American Society of Radiologic Technologists (ASRT) announced it will donate $10,000 to the
News | Imaging | September 11, 2017
September 11, 2017 — Innovatus Imaging Corp., a newly created holding company formed by private equity firm Resilienc
DoseWise is Philips' automated dose management platform

DoseWise is Philips' automated dose management platform.

Sponsored Content | Case Study | Radiation Dose Management | September 08, 2017 | By Kelly Golkin
Continuing education and training are essential in the healthcare industry. Physicians are required to earn a certain...
The GE Healthcare Signa Premier MRI was among the top radiology stories from August 2017

The GE Healthcare Signa Premier MRI was among the top radiology stories from August 2017.

Feature | Imaging | September 01, 2017 | Melinda Taschetta-Millane
Here is the list of the most popular articles and videos on the Imaging Technology News (ITN) magazine website from the...
Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Patient Complexity, Subspecialization Impact List Prices for Radiologists' Services
News | Business | August 15, 2017
A new study by the Harvey L. Neiman Health Policy Institute finds that patient condition complexity and...
Overlay Init