Unprecedented merger activity and provider consolidation are changing the health care industry—and leaving imaging directors with a host of challenges. Meanwhile, the system’s growth also creates a broad network of sites that have to work together to achieve standardization.

Successful systemization in imaging can bring benefits to both the imaging department and the broader system. Imaging spans most hospital departments across inpatient, emergency, and outpatient settings, which is why standardization in imaging has ripple effects beyond the service line.

Breaking imaging systemization down into discrete steps makes the process manageable. To help imaging leaders thoughtfully and effectively do so, we created a comprehensive set of case studies, tools, and other resources that map to the goals laid out in our study, Imaging's System Advantage.

To achieve imaging systemization, programs first need to develop a system-wide leadership structure. Imaging programs should tailor their leadership structure to meet their specific needs, challenges, and demographics.

Case studies:

Integrating Dyad Leadership Throughout Organizational Structure
Page Health, a pseudonymed health system, has a dyad administrative and physician leader overseeing each of its four organizational levels.

Organizing Leadership to Manage a Vast Footprint
Carolinas HealthCare organizes its leadership regionally and then by facility type to effectively manage its imaging program across a broad geographic span.

Aligning Radiology Group and Health System Leadership Structures
Riverside Radiology assigns a physician leader for each partner hospital to facilitate alignment between its group and the health system.

Developing a Committee-Based Leadership Structure
Intermountain Health Care governs through the use of five councils, each with clearly defined responsibilities and methods for tracking progress.

Related resource:

Imaging Governance Structure Diagnostic
Use this diagnostic assessment and accompanying discussion guide to evaluate the strengths and weaknesses of your imaging program's current organizational structure.

Second, imaging programs have to set strategy before turning to the operational goals. Strategic planning involves three parts: setting system-wide strategic priorities, developing a mechanism for tracking progress, and communicating these priorities to the broader team.

Case studies:

Incorporating Site-Level Views into System-Level Goals
University of Pittsburgh Medical Center used a SurveyMonkey survey to gain input from local imaging leaders as they were setting system-level imaging goals and identify leaders willing to spearhead system-level initiatives.

Developing a Bi-Directional Approach to Communication
Emory Healthcare tailors its communication methods based on its audience and subject matter. Their imaging program uses electronic modality communication boards for unilateral communication of policies and procedures to staff and focus luncheons to facilitate conversations between imaging leaders and staff members.

Related resources:

Imaging Strategic Plan Template
Use our template to get direction on four steps of the planning process: performance analysis, market assessment, plan design, and plan evaluation.

Imaging Strategic Scorecard Template
Use this imaging strategic planning scorecard to track system-level and site-specific progress against strategic aims.

Third, your team will need to consider investing in IT infrastructure that can manage imaging while supporting the entire health system—in other words, enterprise imaging. We define enterprise imaging as the reading, storing, viewing, and management of all images and imaging data generated by all providers across all the departments in the health system.

Case studies:

Creating a Frontline Radiology IT Liaison
Southern Illinois Healthcare converted one of their managers into an IT liaison to serve as a bridge between the imaging department and the central IT team and to resolve day-to-day IT challenges.

Identifying a Physician IT Champion
Sutter Health has two radiology IT champions that report directly to the health system CMIO. Sutter has allotted 50% of each physicians’ time to administrative duties.

Establishing a System-Wide Imaging IT Council
Duke University Health System created a system-wide imaging IT council composed of a governance and stakeholder tier to facilitate deployment.

Deploying a Universal Viewer and Intelligent Worklist
Sunshine Radiology deployed a universal workstation to allow radiologists to seamless read across sites of care. The system balanced workloads based on volumes, allowing for greater radiologist productivity. Similarly, vRad created an intelligent worklist that uses an algorithm to assign cases to radiologists, including unbundling trauma studies to ensure efficient, subspecialized reads.

Implementing a Vendor Neutral Archive
Duke University Health System successfully deployed a system-wide vendor neutral archive (VNA). To do this, they identified a physician champion, selected a VNA that met system needs, established criteria to prioritize deployment and demonstrated early project benefits.

Related resources

Imaging Enterprise IT Cheat Sheet
Use the cheat sheet to get a quick primer on enterprise imaging—and learn how imaging leaders can support their health systems in implementing enterprise imaging technology.

Enterprise Imaging IT Infrastructure Resource Grid
Use this grid to track attributes associated with basic, intermediate, and advanced enterprise imaging IT infrastructure and launch a discussion about future investments in image storage.

Health System Image Generation Audit Template
Use this template to learn how many medical images your health system generates in a year—and guide your selection of a vendor neutral archive (VNA) to serve as a repository for all of them.

Vendor-Neutral Archive (VNA) Planning: Business Case and Implementation
Read this research brief to get guidance on your VNA implementation strategy, including how to establish a senior-level working group, define requirements, and identify strategy options.

VNA Vendor Selection Scorecard
Use this scorecard to compare multiple VNA vendors based on financial, operational, and quality considerations.

Fourth, you'll need to establish consistent staff expectations across imaging sites. With uniform staff training, expectations, and policies, staff can be easily shared between sites based on volume, improving productivity for the enter health system.

Related resources:

Technologist Training Compendium
Use the compendium's training goals, training schedule, and orientation checklist to design a training plan for your technologists.

Technologist Staffing Levels Evaluation Tool
Use this tool to help your modality shift managers monitor productivity and identify if there is a need to send staff home.

Finally, your organization needs to focus on achieving financial integration. Financial integration means that the imaging program acts as a single business unit, where financial performance is transparent and strategy focuses on overall imaging system success. Financially integrated programs prioritize system performance and incent individuals to help meet system goals.

Case studies:

Collecting and Sharing Meaningful Financial Data Across the System
At Carolinas Healthcare, site-level imaging leaders report financial performance monthly to the system. System-level leaders then aggregate that data to create a monthly financial report which is shared with stakeholders across the system.

Reducing Equipment Costs through Principled Joint Purchasing, Two Approaches
Sandberg University Medical Center, a pseudonym, uses a prioritization spreadsheet to coordinate capital equipment requests for multiple sites. Similarly, OhioHealth’s Imaging Equipment Committee evaluates equipment needs across the entire system and streamlines vendor contracts.

Measuring Financial Performance at the System Level
Intermountain Healthcare integrated their financial performance at the region- and system-levels; monthly financial performance is included on a comprehensive imaging scorecard that reports performance against system goals.

Incorporating System Financial Performance into Compensation
Intermountain Healthcare redesigned compensation for imaging leadership to better align with system-level financial goals.

Related resource:

The Imaging Leader’s Guide to Working with Finance
Use this guide to get a breakdown of key steps in the transition to financial integration and action items for imaging and finance leaders. You'll also find a glossary of financial terms to help you speak with confidence.