Making the decision to outsource CT and MRI image post processing seems like a slam dunk but be sure your vendor can deliver.
There are many reasons Radiology Administrators should consider outsourcing CT and MRI image post processing. Free up time for technologists to work more closely with patients, avoid the need for physicians to do their own post processing work, remove the expense of purchasing and maintaining expensive third-party software, decrease service gaps when technologists go on vacation and let’s face it, sending the sometimes-mundane work to another technologist to complete, all good reasons for outsourcing. The benefits are clear, and it seems straightforward to find a high-quality vendor, especially when there are only a handful of national providers to choose from, but beware there are some things you need to consider before making the leap.
Quality of Service
It seems obvious that a provider of such important services needs to be accurate and reproducible in their work, but not all vendors are created equal. There are service providers that put an emphasis on the quantity of work their technologists can complete and thus quality may suffer. Further, when the work takes place offshore there may be some confusion on post processing protocols and exactly what is to be measured, which leads to inaccuracies. What is more, when physicians have questions about specific studies, the technologist who performed the analysis can be nearly impossible to reach if they are offshore. When considering outsourcing make sure the service is in the US and has sufficient quality controls in place to ensure all protocols are followed without compromise.
Timeliness of Service
The necessity for on time delivery of results varies between study types. If you are submitting a routine Coronary CTA exam for reformats and measurements, there typically isn’t a problem getting results back in a timely manner. However, if you have a stroke patient and you are looking for a head and neck CTA it’s very likely you need that data back quickly. Unless you are planning on sending only non-acute studies, expectations must be set, and your service provider must have a way of differentiating and prioritizing studies according to study type.
Direct Contact with the Analyst Doing the Work
Your vendor should provide a straightforward way for you to contact the analyst doing the post processing work for you. This is extremely important; if your post processing provider is using a pool of analysts working from a shared worklist you lose the ability to build a relationship with that analyst and they do not learn about the specific low-level needs of your physicians. A service-oriented provider of post processing services needs to allow for multiple methods (email, text, phone) to contact a primary and secondary analyst assigned to your account. If physicians have a question about post processing or are looking for an additional measurement or view, they should be able to contact that individual analyst within just a few minutes to request a modification.
Imaging centers typically employ multiple physicians, and it is highly likely many of them have preferred workflows depending upon the study type they are interpreting. Your outsourced image post processing vendor needs to be able to accommodate as many of these workflows and physician preferences as possible. For example, some providers may have multiple disciplines interacting with patient studies; surgeons, cardiologists, radiologists – they all have reason to be looking at images and they may have different requirements regarding measurements, reformats and more. If your post processing service provider is not able to generate views, measurements and reports based on study type, severity of disease, or customized reports per discipline, your satisfaction with that provider will suffer. Nominally a post processing service provider will provide a wide range of reports but will also provide internet based, real time, secure access to the patient study. In this scenario the physicians will have a comprehensive report but will also have the option of opening the study from a web-based browser window and make slight adjustments of their own. If desired, that physician will also be able to reach their outsourced analyst and discuss the case within the context of the software within minutes as well.
Complete Service Offering
Your preferred image post processing vendor should offer a full range of post processing services, using the most up to date, industry standard, FDA cleared software. Having to engage with more than one post processing vendor for specific study types would be extremely inconvenient and counterproductive to streamlining departmental workflow. When interviewing potential vendors be sure to ask questions about not only which type of analysis they can provide but also ask about their monthly volume of those study types. This will give you a good indication of not only the breadth of service but also their proficiency.
The Process of Choosing a Vendor
Be sure to look at a minimum of two service providers and ask lots of detailed questions as they relate to your specific situation. Ask about compatibility with PACS, modalities and modality manufacturers, network types (LAN, WAN, Cloud), acquisition protocols, software they use routinely and for niche applications and more. The right service provider will be able to accommodate your routine workflow within the context of your network infrastructure. That service provider should be able to answer your questions and provide you with a proposal that meets your needs within 12 hours of having a fact-finding demonstration of the service. The provider should provide 3 to 5 no charge analysis of sample studies and follow up quickly with your physicians to ensure their analysis protocol requirements are met. The process of selecting a vendor should take no more than a few weeks depending upon the availability of your resources (physician, radiology administrator, legal / procurement).
Sometimes it feels like the hardest part of selecting a vendor is making the decision to start the process; the reasons to make the move to outsourcing are obvious. My recommendation is to make a few phone calls, engage with a couple of vendors, talk with some reference accounts, select the vendor you trust and start outsourcing, you will be thrilled with the change.
About the author. Daniel D. Bickford is President of Pintail Strategic Consulting which provides sales and marketing services to the diagnostic imaging industry, including Precision Image Analysis. Daniel was co-founder of Confirma, Inc., the pioneer of the breast MRI CAD market and manufacturer of CADstream.