Hi, everyone. This is Lucas Voss with Becker's
Healthcare. Thanks so much for tuning in to
the Becker's Healthcare podcast series. It's great to
have you. Today, we're talking about scaling outpatient
care, lessons and access, workforce, and advocacy.
And joining me for today's discussion are three
fantastic
guests. First, Carl Galloway, chief operating officer at
Wake Radiology, and we're also joined by doctor
Brent Townsend, president and managing partner also at
Wake Radiology
and a pediatric
radiologist. And rounding out the conversation is Jason
Weschler. He's the vice president of outpatient solutions
at Siemens Health and Ears. Thank you all
for being here today. It's so great to
have you. We have a ton to discuss,
so I wanna hop right into
the conversation.
As we're seeing demand continuing to shift into
outpatient settings, I'd love to know
where you're seeing the most persistent access bottlenecks
today. And, again, we're talking about geography, scheduling
capacity, staffing, referral process, all of these different
factors, very complex.
And which of those
is proving
hardest
to solve at scale? Doctor Townsend, I'd love
to start off with you.
Well, thanks, and thanks for having us here.
For me, as president and managing partner, the
biggest bottleneck remains the shortage of radiologists
relative to the growth in the volume of
work.
Here at Wake Radiology, we have been fortunate
enough to be able to recruit due to
several advantages,
practice stability,
our reputation for quality, our location here in
the Triangle Of North Carolina,
good relationships with two excellent training programs in
our backyard in Duke and UNC.
And that recruiting success has allowed us to
handle our organic growth
while maintaining quality and short turnaround times.
However, in order to achieve our goals of
expanding even further
and providing even more access to our patients,
we need to be able to recruit even
more.
Paul, from your perspective as chief operating officer,
what does this look like?
I'd say from an operational standpoint,
one of our main bottlenecks has been the
technology shortage in our market.
We are
in one of the fastest growing areas in
the country.
We have several large health systems
as well as other outpatient imaging providers, so
we find ourselves competing for the same
kind of smaller talent pool.
So what we've tried to do,
as an organization
is focus on internal
workforce development. We've been cross training
our technologists,
across multiple modalities.
We've also,
been very collaborative with our local community college
programs
to offer
student technologist positions,
apprenticeships,
internships,
hoping to build a sustainable
pipeline of some future technologists.
And while we're seeing some
incremental positive outcomes from these efforts.
The demand, the volume that we're,
experiencing, it's been very difficult to meet the
staffing challenges.
Jason, is this something that you're seeing nationwide?
I'm assuming these are trends that you've heard
about quite a bit and you're familiar with.
But, again, from where you're sitting too, what
does this look like? Are these familiar trends
that you're seeing?
So glad to be here. And absolutely, we
are seeing these trends across the country. There's
certainly some regional differences.
Mhmm.
But one of the key things we also
know is that
the best outcomes for patients are tied to
being able to to get access to
these appointments in a timely manner in their
communities.
And I think what both doctor Countsen and
Carl have shared
are representative trends.
We're also seeing a need for technologies
to help
accelerate,
care and availability, whether it's remote scanning
and
emulating. I think what Carl and the team
at Wake Radiology are doing in terms of
workforce development being another key theme.
Carl, again, you've touched a little bit on
the operational side of this and what this
looks like from where you're sitting. Right? When
you're looking at day to day operations,
which is certainly crucial,
when you're trying to expand access without simply
adding cost, what are some of those operational
or technology levers that you've seen really deliver
the most meaningful results?
I think this is a really important question,
especially
as we are in a county where,
we're looking at
our MRI certificate of need,
going away in the fall this year. Certainly,
the challenges are
how do we scale up without,
risk of increasing our cost. So
our team has taken
a creative approach.
I would say some of the most effective
changes we've made
has been to implement
flexible work shift models that's allowed us to
better match staffing levels with patient volumes more
efficiently. That's allowing for better access to care
at different times. We're doing evening shifts. We're
doing weekend. I think that's
really helping as far as patient convenience, so
that's been effective.
We're using digital tools that were already available
to us to reduce the administrative
tasks that were previously handled by technologists, allowing
them to focus more on patient care and
patient experience.
We've also,
added internal support teams
to allow for better patient throughput.
And one area that we've really focused on
recently is protocol management and modalities such as
MRI, CT, and ultrasound.
That's allowed us to reduce exam duration times.
So,
I think that has resulted in scanning efficiencies.
All of these measures together have allowed us
to increase our capacity and patient access
without a significant increase in cost.
And it also trickles down to the patient
experience as you've mentioned. Right? It's shorter wait
times. There's more access, which certainly helps the
patient too. And and doctor Townsend, I I'd
love to tap on your perspective here too.
Right? As a practicing radiologist,
certainly as a managing partner as well.
How do you think about balancing the needs
of patients, staff, and the organization? Again, when
making those decisions about what workflows need to
be redesigned,
how do we support greater access, and and
how do you balance all of this with
making sure, okay, there's growth for the organization,
but we're also hate having clinical quality?
Well, that is, absolutely a a crucial question
for all, health care practitioners to be answering
nowadays.
Because as you said, patient care and quality
always have to come first. And, yes, it
is challenging to balance that with the ever
increasing expectations
for patient access and for system wide productivity.
On the radiologist side, there are a few
things that we have done. We have been
very intentional with our growth plan, not taking
on more new work than we can reasonably
handle.
And we have set reasonable expectations for productivity
from our radiologists, and then we help them
achieve those goals with support.
For example, we have reading room coordinators who
can answer the phone and send messages to
referring physicians, and that helps limit the interruptions
in the radiologist workflow.
We're using AI to help with the repetitive
but necessary tasks.
For example, if I'm going to compare
a study to the study that was done
three months ago or a year ago, one
of the things that has to be done
is that we line up the studies correctly
so that I can make a direct comparison
of the liver on one image to the
liver in the prior image. And we have
AI tools that can help us do that
automatically.
Also, we're using AI tools that can help
us with report correction and impression generation.
And by removing some of these tasks from
the radiologist's plate,
that allows us to spend more time actually
interpreting the images, which is what we can
do to make the most difference in the
patient's lives.
And lastly, we are aggressively addressing burnout
by looking at work life balance.
We are prioritizing giving radiologists protective time off
before and after call weekends, help them recover,
and we have provided home workstations for all
radiologists.
This allows them to read remotely or outside
of typical work hours, which gives them flexibility
and some autonomy, which really helps
reduce some of that stress level from the
increasing productivity demands.
Yeah. I love that you've highlighted that because,
again, less stress, the more radiologists can focus
on the patient and provide that better patient
experience, which is so crucial.
Jason,
working with providers across the country and certainly
what we've just heard,
what separates organizations that successfully
scale outpatient care
from those, again, that still struggle despite making
investments in new sites or even new equipment?
So I think what we're seeing across the
country are the successful programs, be it independent
practices or large health systems,
have a few common ingredients.
They take time to really plan out what
the needs are. So they understand their markets,
their communities,
And that's
providing for a good patient experience, but also
thinking about what are the referral patterns, what
are the community health, population health patterns
so that the right services could be aligned
with the community needs.
They're paying attention as both doctor Townsend and
Parl have said about what is the right
scale, what is the right workflow,
making sure that the equipment
they're bringing in isn't necessarily at the same,
set of bells and whistles a health system
or a hospital might have.
We're really focused on the key procedures they
need
so that they're maximizing the value for the
patients and the community they're engaged with.
And it's looking at the technologies available.
So we've heard about burnout workflow,
staff efficiency. So how you leverage different AI
tools, different workflows and protocols,
different acceleration
softwares on systems to really become very efficient
and very consistent
so that you're given the best outcomes for
your patients, which gives them the best experience,
all become key factors to being a successful
growing outpatient
group.
Yeah. Technology really becomes the enabler here for
all of the processes that we've highlighted throughout
our conversation.
I wanna shift our focus a little bit
to something that
there might not be as much control over
as some of the factors you've mentioned,
across our conversation today.
I'd love to talk a little bit about
which policy or regulatory changes have and and
can continue
helping to accelerate that outpatient
expansion.
Paula, I'd love to start off with you
on this one.
Well, I can't speak to a specific policy,
but I will say that we are seeing
a trend where payers are encouraging health systems
to move outpatient imaging out of their hospitals
and into the community practices.
I think that allows the hospital to better
manage inpatient care where their focus needs to
be, and that's allowing us
to also
help and support
patient care.
And
since we have a hospital partner, that has
been a great measure of support for them.
So I would say that
that's where I see some of our role
in some of the policy and regulatory changes.
Yeah. Doctor Townsend, I'm assuming similar for you.
What are you seeing there on that front?
I would exact I would echo exactly what
miss Galloway just said.
We have seen and has been proven that
in appropriate patient populations,
outpatient care is a more cost effective way
to deliver care, and it provides greater patient
satisfaction.
I the payers recognize that. The patients recognize
that.
And we're seeing that in all specialties, not
just radiology. So as the entire health care
system
looks to become more efficient, I do think
we'll see more bifurcation where there are definitely
some things that have to be done or
strongly encouraged to be done in the outpatient
setting and some things that are, no, this
is going to be done in the hospital.
We're gonna see that trend continue. And as
radiologists, we need to be prepared to serve
both populations.
You know, we have relationships. We have the
outpatient imaging offices,
but then we also
service hospitals on the inpatient side as well.
We wanna take care of the patients
wherever the patients get their care.
Jason,
from where you're sitting, right, the conversations that
you're having, what does this look like from
a regulatory perspective? What are you paying close
attention to?
So so I'd say what we're seeing
are and paying a lot of attention to
are changes around certificate of need.
So Paul mentioned that that's something they were
looking at for one of their local MRs.
And what we're seeing across the country is
the state by state
changes
around requirements or limitations
of adding new sites of care
are evolving very quickly. Things like the inpatient
only list are being phased out.
And what that's doing is
it has the potential to bring more access
to
patients and communities across the country.
So we're watching it to make sure that
we can support
our customers,
our clinicians who are really trying to bring
back care
with the right solutions that will help have
sites up faster and delivering care sooner.
It all comes back to being able to
care better for the patient, being able to
provide better care to communities across the country,
which is so crucial.
Paul, doctor Townsend and Jason, it's so fantastic
to have you for this conversation.
We've touched so much ground here today throughout
our time together. I do wanna close this
out with final takeaways from from what we've
touched on or what you think is probably
some of the most important pieces of our
conversation.
Paula, I start off with you here. What
will your final takeaway be from from today?
I am encouraged by the fact that our
conversation
centers around patient experience and quality.
I think those two two things have to
be at top of mind in whatever we
do.
And I think that as we all think
about
our strategic planning for the next few years,
making sure we're incorporating,
ways that we can be flexible,
allow for
adjustments as we go because
things are changing at a fast pace,
and we need to be ready to tackle
those
as they come.
Doctor Townsend?
I would say, again, the only thing that's
constant is change. So we have to be
creative and innovative in how we meet the
demands of patient access. We absolutely have to
keep quality and patient care top of mind.
And I think one thing that we will
all need to do is be aware of
and increase our involvement in local, state, and
national conversations
regarding patient care, remembering that we are
physicians,
administrators. We all have patient care in mind,
so let's advocate for those patients.
Yeah. Jason?
I'm excited
and optimistic
when I look ahead. I mean, conversations like
this where
consistently we're talking about patient care, quality,
access,
flexibility.
That's the future of health care.
And for all of us, it's a personal
topic. We all have loved ones who need
care.
So so for me, it's continuing to partner,
to collaborate,
to
use technology
as a way of augmenting
and supporting clinicians and service delivery
that lead to a lot of good today
and down the road.
Yeah.
Well, Paul, doctor Townsend, Jason,
again, thank you so much for being here
today for sharing these insights. Again, we touched
on so many different things. We also want
to thank our podcast sponsors, Z Men's Health
and Ears, for bringing us together
for this conversation,
and you can tune into more podcasts from
Becker's Healthcare by visiting our podcast page at
begrashospitalreview.com.