Applied Radiology

adiology administrators play a crucial role in the management of medical imaging departments and imaging centers. In an effort to enhance the value of the radiology administrator and to provide a standardized assessment of the knowledge and performance of those who fill this position, the American Healthcare Radiology Administrators (AHRA) has developed a Certified Radiology Administrator (CRA) Program.

"As far back as 10 years ago, the AHRA began soliciting feedback from members about how to enhance radiology administrators," said Thomas Redman, Director of Medical Imaging, Prince William Hospital, Manassas, VA, and Chair of the AHRA's Radiology Administration Certification Commission. "The ideas considered included creating a degree program or an advanced certification. Because many radiology administrators came up through the technical ranks-many having been technologists at one time-they were used to the idea of certification. It was a natural progression for those reaching the administrative arena to say that some sort of certification would enhance their status in the profession."

Following a feasibility study and other market research, including interviewing more than 400 AHRA members, Redman recalls, "It was decided that a certification program was the best opportunity to generate the greatest impact on the industry, especially since there weren't any other certification programs available in radiology administration."

Based on the data collected, the CRA program was developed in 2001 with the help of a 5-year, $1 million grant from Kodak Health Imaging (Rochester, NY). The first certification exam was administered in July 2002.

"Some of the CRA objectives," ex-plained Redman, "were to raise the business acumen of imaging administrators and to provide a standardized assessment of the performance of a radiology administrator. We also wanted to recognize professionals for their expertise and the way to get that recognition in radiology management is through this certification process."

In order to obtain this certification, radiology administration personnel must first qualify to sit for the exam based on 7-point eligibility criteria. Points are earned through education, experience, and/or credentials (Table). Candidates must have at least 1 point earned through education or have a minimum of 10 years' experience without an education point. All experience must be in human radiology and a maximum of 1 point can be obtained through inclusion in 1 of the following registries: American Registry of Radiologic Technologists, American Registry of Diagnostic Medical Sonographers, or Nuclear Medicine Technology Certification Board.

Once qualified, applicants can take the test in a written format at the AHRA's Annual Meeting and Exposition or in a computer-based format. The 2005 Summer exam will be offered on Saturday, August 6th, before the 33rd Annual Meeting and Exposition in San Antonio, TX. The Fall computer-based exam will be held on Friday, November 4th, at 115 CompUSA testing centers nationwide. Applications for that exam must be postmarked by September 20, 2005. The cost for the exam is $300 plus a $50 application fee to verify eligibility. Applicants do not need to be a member of the AHRA.

The test consists of 185 questions based on 5 management domain areas:

• Human Resource Management
• Asset Resource Management
• Fiscal Management
• Operations Management
• Communication and Information Management Approximately 30% of the questions are based on knowledge, 40% test application skills (ie, problem solving), and 30% are analysis."Once certified, CRAs need 36 continuing education (CE) credits every

3 years to maintain their credentials," explained Karen Guy, AHRA Communications Director. "With the CRA process, we focus the CE on management and leadership," added Redman. "In the technical arena, CE typically focuses on specific skill sets or functions related to what you are doing. For CRAs we say, 'Now you are in management. Now you are in a leadership role, and we want you to focus on that.'"

To date, the exam has been administered 8 times to a total of 586 people. Of those, 485 have passed and may use the CRA credentials. "From those who have taken the exam, we have heard that they get the personal satisfaction of validating what they know and what they are doing," said Redman.

Looking forward, Redman said, "We hope that this will become the standard in the industry; that in the future, employers will look at this as a minimum qualification to run an imaging department or a section of imaging modalities. This program also shows colleagues and peers in other professions that we meet a certain minimum standard of criteria and qualifications."

HealthIntell offers real-time patient feedback

HealthIntell LLC (Wilmette, IL) is currently offering a patient satisfaction tool designed to provide real-time feedback to imaging centers.

PatientIntell is a survey program that uses e-mail, in-center kiosks, and traditional paper surveys to obtain patient assessments. The results are instantly available online.

The customizable surveys, explained HealthIntell's President Patricia "typically ask about how the patient selected the center, whether or not their referring physician gave them a choice of imaging centers, how the scheduling process went, how long they had to wait to get an appointment, how long they had to wait before getting taken back for their procedure, how the front desk staff was, how the technical staff was, whether the office was clean, what their experience was like overall, and whether they would recommend the center to a friend."

"If the survey is completed online, through a kiosk, or via e-mail, the results are compiled in real time into online reports," she said. Data from surveys returned in the mail are compiled by staff members at HealthIntell and are also added to the database.

The reports show each imaging department or center their patients' assessment of their performance across a number of criteria and how their center compares with similar imaging centers in the database. "There are 6 different criteria that we benchmark against: volume, modality, payer mix, staffing levels, location, and ownership model," said Riskind.

HealthIntell's clients can access their reports at any time via the company's web site using their own unique login. This data can then be used by the imaging center to assess their performance and to search for any problem areas. For example, Riskind noted, "If an imaging center sees that they are having problems in scheduling, they can modify the scheduling approach; or if they see that there is a backlog, they can add staff."

The company will also offer a product designed to solicit feedback from referring physicians, PhysicianIntell. Riskind explained, "We are developing a tool that is very similar to PatientIntell that will allow the physician to complete a survey online. We will then have those results compiled in real time for participating centers." The online version of this tool is expected to be available in September 2005.

"On the referring physician side, we have had great luck in understanding the referring physicians' 'hot buttons' and what to do differently," she explained. "In one particular case, we saw that referring physicians who had a personal relationship with the radiologists at an imaging center were much more apt to be loyal and high referrers to that center. As a result, the imaging center established an incentive program for their radiologists to make more outbound calls instead of just faxing results to the referring physician, to hold more 'lunch and learns,' and to hold more symposia. Since then, they have seen a dramatic change in the number of referrals they are getting. They are now going to redo the survey using PhysicianIntell to measure the impact that their outreach programs have had."

"Our biggest differentiator is that we try to compile the data instantly so that you can see on a daily basis how your performance is going," concluded Riskind. "We also capture comments if a patient or a referring physician has specific things to say. Sometimes the comments are the most helpful part. If you use the information, you can actually make changes, save money, and grow your business."