Feature | March 18, 2011 | Greg Rose

Raising the Bar for the Industry

This article appeared as an introduction to the Teleradiology Services comparison chart.

This is the sixth straight year that Imaging Technology News has featured a comparison chart on teleradiology services. When you publically compare vendors, they know what they are up against, re-evaluate their offerings and hopefully make improvements.

During the last five years, there have been many comparisons of teleradiology services with high detail, frequency and emotion. This has come in the form of charts, articles, blogs, public presentations, advertisements, KLAS surveys and, of course, RFPs. The good news is that continuous vendor comparisons and daily scrutiny of their work have dramatically upped the teleradiology companies' game. With constant feedback and intense competition, they are at the top of their game. And when they feel they are even with their opponents, they are compelled to revisit their playbook to improve their standard plays and come up with new and innovative plays.

The "bad" news is that such comparisons have not been made regarding the quality of services provided by various onsite radiology groups throughout the market since, after all, they own the contract and aren't in competition with anyone. Or so the thinking goes.

The Times They Are a Changin'
The advancement of teleradiology groups allows them to replace the entirety of even a large onsite radiology group, no matter how long they have been around. Onsite groups should be aware of the larger and greater variety of services offered by hungry competitors and the possibility of sudden replacement.

While onsite groups may review this comparison chart with the intent of selecting a teleradiology group, I suggest they also review the conditions along the left side of the page, as these are service targets for groups that could potentially replace them. If yours is an onsite group, ask yourself whether you are offering the same level of service that these groups do. Teleradiology companies are in tune with the interests of the CEOs, radiology directors, emergency room docs, and clinicians, and they provide services to address their interests. Do you?

A Call to Arms
No one steals anyone's girlfriend; they are the better boyfriend. Remember, we rads don't own our contracts, we service them. The following chart should help prepare onsite radiologists to begin the process of securing their practices. An emotional label for companies that could replace whole groups is "predators." A functional label is "competitors." I submit that once you decide to view them as competitors, you begin the process of creating improvements rather than excuses. Keep your practice. Do what it takes to be the best solution.

There are a number of rather simple activities that can dramatically strengthen your practice and don't cost much time or effort. Review this chart for ideas, since these are the items various hospital and radiology decision-makers focus on. Consider asking your current teleradiology group what makes them so good. If they are cooperative and not after your practice, they will probably tell you. Be the best solution - no one replaces the best solution.

The Crystal Ball
If last year is any indication, the future of teleradiology will remain dynamic. The pros and cons of the 2010 merger of the two biggest companies have been stated, but we have yet to see the validity of those predictions. Pricing seems to have stabilized, but there are still complaints about teleradiology "commoditizing" radiology.

One way to help curb the commoditization is for interested parties to stop asking teleradiology companies to lower their pricing, with the threat of changing services if they don't. Another way is for interested parties to stop choosing their teleradiology companies primarily based on price rather than quality and service offerings.

By the way, as onsite radiology groups pressure teleradiology companies to lower their pricing, teleradiology companies become a more attractive deal to a CFO. Center for Medicare and Medicaid (CMS) credentialing issues don’t seem nailed down yet - perhaps we'll finally see national accreditation for teleradiology. U.S.-based teleradiology companies are increasing their fraction of final reads. More teleradiology companies are doing overreads and subspecialty work. There are some onsite groups reclaiming at least some of their call and looking for more teleradiology work. Discrepancy rates continue to have high error bars for teleradiology companies doing prelims, since there is a range of quality assurance (QA)participation from facilities.

Some of the top teleradiology companies continue to put resources into their own radiology information systems (RIS) and make it available to onsite groups, allowing them to cover their other facilities during the day. There remains an uneasiness towards some teleradiology companies from onsite groups. In the next year, I believe a clearer picture will emerge as to the identities of the "predators, competitors and cooperators."

Greg Rose is president and CEO of Rays

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