The Metamorphosis of a Practice

As the health care industry moves toward value and away from volume, some facilities are finding both challenges and opportunities as they turn to a more service-oriented business model.


It is a conundrum most radiologists face at some point in their careers: how to stay true to the needs of their patients while consistently meeting business goals for their practices.

As the health care industry moves toward value and away from volume, some facilities are finding both challenges and opportunities as they turn to a more service-oriented business model. The benefits of strategic planning have become paramount as radiology practices begin to change how they respond to the multifaceted needs of their patients more efficiently and effectively. Ricardo C. Cury, MD, president and CEO of Radiology Associates of South Florida (RASF) and director of cardiac imaging at Baptist Hospital of Miami and BaptistCardiac and Vascular Institute, has been a leading force for helping radiologists transition into becoming consultants with the ability to develop clinical pathways based on Appropriateness Criteria® for imaging, thereby enhancing coordination of care.

Formulating a Strategy

To kick off his own practice’s transformation, Cury’s team began holding annual strategic planning sessions. These planning sessions helped the team formulate a mission statement, prioritize goals for the practice, establish context for the strategy by examining internal and external issues, and evaluate the practice’s strengths, weaknesses, opportunities, and threats — also known as a SWOT analysis (see sidebar). Looking back at the process, Cury suggests that a critical first step in the strategic planning process is to develop a formal mission statement — including specifying the practice’s vision and core values. Next, it is time to define specific goals and objectives —and identify actual timelines for achieving those goals — in order to align all members of your organization with a shared direction.

Equally important, the practice’s leadership needs to be accountable for executing the plan and achieving the established goals. In that context, it is imperative to establish metrics by which your organization can measure its progress. For Cury, one of the most important goals within the strategic planning process involves strengthening the radiologist and hospital relationship. “We need to answer how we are adding value to our hospital partner and what activities we are implementing to contribute additional value,” states Cury. Other objectives include improving personal service in the delivery of care to patients and referring physicians, investing in IT and marketing initiatives (such as creating an annual report), participating in community events involving breast cancer awareness, and redesigning the practice’s website. When Cury’s practice implemented strategic planning, the team developed metrics for each of its goals and hired a data analyst to review measurements, oversee reports on subspecialty expertise, and tally surveys on patient and physician satisfaction.

For the next phase of the strategic planning cycle, Cury suggests looking at both external and internal issues affecting a radiology practice. For example, this could involve considering how health care reform is impacting new payment models — particularly in the evolution from fee-for-service to quality-based payments, such as pay-for-performance, bundled payments, and shared savings. He also recommends observing how other practices are positioning themselves during this time of transition. For internal issues, Cury believes it is crucial to have governance and oversight to create a successful strategic plan.

Having a small core group serving on an executive committee, with oversight by a board of directors, creates a sense of support that is vital for implementation. “I think it gets everyone in your practice on board with the same vision,” he states.

The Tools of Strategic Planning

Here are some sample tools that can help you make the transition from volume to value in your practice.

Sample SWOT analysis
Sample mission statement 
Examples of goals and metrics
Cury’s Radiology Leadership InstituteTM presentation about strategic planning 

Executing the Plan

Cury says that while the strategic planning process is critical, departments should spend the majority of their time on the execution of the plan. According to Cury, doing the work of increasing the visibility of radiologists is a key factor for success. Being part of hospital committees, establishing clinical pathways that lead to the best imaging test for specific conditions, improving imaging protocols to ensure the quality of images, and having a peer-review process that provides subspecialty expertise can all be part of creating a more visible presence for radiology. Cury provides a key example of how his practice is working to improve radiology visibility among its stakeholders, including referring physicians and hospital administrators. RASF implemented an initiative called Radiology Rounds, where radiologists perform rounds with other clinicians on the hospital floor. They currently have two pilot programs operating, one in neuroradiology and one in cardiac imaging.

The benefits of strategic planning have become paramount as radiology practices begin to change how they respond to the multifaceted needs of their patients.

“The radiologists conducting Radiology Rounds have made a major impact with our referring physicians and the administration by offering just 30 minutes of their time,” he explains. “It has also had an effect on patient care and satisfaction. We review images on an iPad directly with patients. We can see the reaction of patients as they understand how they can change and become more compliant with medications and the modification of risk factors.” Cury admits that the strategic planning cycle is a continuous journey as changes to health care and new payment models will impact radiologists far into the future. “Strategic planning lets you take a proactive approach by anticipating changes in the industry while engaging stakeholders who will need to lead that change,” he says. “The key component for strategic planning is engaging all radiologists, not only in your practice but also across the entire radiology community. And if we continually focus on what is best for the patient, then everything else will follow.”

By Amena Hassan, freelance writer for ACR Press

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