Commercial Teleradiology Commercial Teleradiology Interpretation of Interpretation of

Musculoskeletal (MSK) MRI Musculoskeletal (MSK) MRI Studies: Educational and Studies: Educational and Financial Rewards for an Financial Rewards for an

Academic Radiology Academic Radiology DepartmentDepartment

Joe Lacy M.D. MBA, Greg Chaljub M.D., Randy Ernst M.D., Elizabeth Jones M.D., Aytekin Oto M.D., Leonard Swischuk M.D.

BACKGROUNDBACKGROUND

Academic Radiology DepartmentAcademic Radiology Department

State University Medical CenterState University Medical Center

Indigent PopulationIndigent Population

State Departmental Budget CutsState Departmental Budget Cuts

TELERADIOLOGYTELERADIOLOGY

Texas Department of Criminal JusticeTexas Department of Criminal Justice AntarcticaAntarctica Cruise ShipsCruise Ships NASANASA

DEPARTMENTAL OPPORTUNITYDEPARTMENTAL OPPORTUNITY

Commercial Imaging Center Required Commercial Imaging Center Required Radiological InterpretationRadiological Interpretation

ExpertiseExpertise Prior experience with teleradiologyPrior experience with teleradiology

PURPOSEPURPOSE

To evaluate the principle effects of a To evaluate the principle effects of a commercial venture interpreting commercial venture interpreting images from outside MRI imaging images from outside MRI imaging centers.centers.

MATERIALS AND METHODSMATERIALS AND METHODS

• Total number of intrinsic and extrinsic MSK Total number of intrinsic and extrinsic MSK MRI studies volume from 2001 through 2004 MRI studies volume from 2001 through 2004 was queried via Radiology Information was queried via Radiology Information Systems and compared.Systems and compared.

• A new MSK MRI rotation was established.A new MSK MRI rotation was established.• Residents were surveyed regarding MSK MRI Residents were surveyed regarding MSK MRI

rotation participation and confidence in rotation participation and confidence in interpreting MSK MRI.interpreting MSK MRI.

• Limited financial statement interpretation Limited financial statement interpretation was performed specifically targeting was performed specifically targeting budgeted departmental revenue changes and budgeted departmental revenue changes and return on investment.return on investment.

RESIDENT SURVEYRESIDENT SURVEY

1.1. Have you rotated through the MSK Have you rotated through the MSK MRI rotation?MRI rotation?

2.2. Did participation in the MSK MRI Did participation in the MSK MRI rotation improve your confidence rotation improve your confidence reading MSK MRI?reading MSK MRI?

RESULTSRESULTSINCREASED MSK MRI VolumeINCREASED MSK MRI Volume

make a graphmake a graph

Year2001 2002 2003 2004 ٭

MSK Studies UTMB 797 1077 1181 605Partner 573 1654 1532 717Partner 324 1073

Total 1370 2731 3037 2395increase over UTMB % 71.89% 153.57% 157.15% 295.87%Partial Fiscal Year *

NEWNEW MSK MRI Rotation MSK MRI Rotation

No dilution of teaching.No dilution of teaching. No increased FTE’sNo increased FTE’s

RESIDENT SURVEYRESIDENT SURVEY

16/27 Residents rotated through MSK 16/27 Residents rotated through MSK MRI.MRI.

All 16 reported INCREASED All 16 reported INCREASED CONFIDENCE READING MSK MRICONFIDENCE READING MSK MRI

Targeted Financial AnalysisTargeted Financial Analysis

Implementation CostsImplementation Costs Hardware (specific)Hardware (specific) Contract Networking CostsContract Networking Costs

Payback Period - Less Than 1 Year.Payback Period - Less Than 1 Year.

Return Exceeded Risks!Return Exceeded Risks!

Targeted Financial AnalysisTargeted Financial Analysis

Projected Teleradiology Revenue Projected Teleradiology Revenue Exceeds 10% of Budgeted Exceeds 10% of Budgeted Departmental RevenueDepartmental Revenue

Teleradiology Collection Rate = 100%Teleradiology Collection Rate = 100%

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Increased MSK MRI Volume Creating a Increased MSK MRI Volume Creating a New MSK MRI Rotation.New MSK MRI Rotation.• Increased Resident ConfidenceIncreased Resident Confidence• No Dilution in Teaching.No Dilution in Teaching.

Increased Departmental RevenueIncreased Departmental Revenue• No Service Decrease or Employee LossNo Service Decrease or Employee Loss• No Additional FTE requiredNo Additional FTE required

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Increased MSK MRI VolumeIncreased MSK MRI Volume Increased Resident ConfidenceIncreased Resident Confidence Improved Professional SkillsImproved Professional Skills

Increased Departmental RevenueIncreased Departmental Revenue No Service Decrease or Employee No Service Decrease or Employee

LossLoss No Additional FTE requiredNo Additional FTE required

Combine = conclusionCombine = conclusion

The result is improved resident The result is improved resident clinical training to interpret MRIs and clinical training to interpret MRIs and meet client expectations while meet client expectations while simultaneously improving simultaneously improving departmental financial goals. departmental financial goals.