The Reading Room

Interventional radiology growth outlook: Sunny with a chance of system value

by Erin Lane

This is the last post in our weekly series on conversations we had with interventional radiology (IR) leaders who represent programs in a variety of settings, including health systems, children’s hospitals, AMCs, cancer centers, and more. 

Over the past year, we've observed a clear surge in interest among our members—including imaging leaders, radiology groups, and vendors—in interventional radiology (IR). And for good reason—using minimally invasive image-guided techniques, interventional radiologists can provide high quality care at a lower cost than many surgical alternatives. Providing high-quality, cost-effective care becomes increasingly important as we move toward a value-based health care environment.

But developing successful interventional radiology programs poses a unique set of challenges that imaging leaders must address. So we set out to understand the IR market.

Three key insights about the interventional radiology landscape

1. It’s not all about vascular—diverse IR services have strong growth outlooks

Whereas vascular work previously ruled the interventional radiologist’s book of business, many programs have left those procedures to the vascular surgeons to reduce turf conflicts. Instead, IRs are capturing referrals from two new areas: non-procedure based specialists and patients themselves.

Physicians in non-procedure based specialties, such as medical oncology and pediatrics, are a strong referral source for interventional radiology because they don’t offer competing services. Additionally, for several organizations, about 50% of IR referrals came directly from patients, many having shopped for surgical alternatives online. IR programs looking to grow should target these two groups: non-competing specialists and patients themselves.

2. Interventional radiology programs struggle to clearly communicate their value

Generally, the radiology department oversees both diagnostic and interventional radiology, which can cause physicians and administrators to view the two specialties as analogous in terms of both specialist role and necessary resources. Without understanding the IR scope of services, physicians send referrals elsewhere—stunting IR volumes. This misunderstanding also hinders IR program development as administrators do not see a need for additional resources, such as patient-friendly waiting rooms. Programs must develop a clear message about their role and program goals to grow service offerings and capture referrals.

3. Interventional radiology’s value proposition aligns with future market trends

IR’s growth outlook is strong as it mirrors three significant health care trends:

  • Cost-effective care: Lower cost high quality care sets organizations up for success in risk-based payment models
  • Attracts consumers: The minimally invasive nature of interventional procedures attracts patients who shop before receiving care
  • Available outpatient: With a quick procedure and recovery time, many IR services are outpatient, mirroring the broader trend away from inpatient to outpatient and freestanding settings

Lessons from IR programs in a variety of settings

Over the past several weeks we’ve been blogging about IR, highlighting conversations with leaders in the field and providing strategic guidance for managing interventional programs. In case you missed it, here's a quick recap:

Academic medical center and teaching hospital: MedStar Georgetown

  • IRs involved in research can use publications to demonstrate expertise and appeal to referring providers

    At research-based programs, interventional radiologists can leverage research to educate providers and secure referrals. As physicians build a resume of publications, referring providers view IRs as experts in the field and feel more comfortable referring patients to Georgetown’s program.

  • Scheduling adaptability allows IR to demonstrate value by accommodating emergent cases

    Unlike traditional ORs, Georgetown’s IR suites are not scheduled in blocks or reserved for certain physicians. This allows them to adjust the schedule to accommodate emergency cases, while also delivering timely care for scheduled procedures. Georgetown’s ability to accommodate both emergency and scheduled cases with ease is a major factor driving growth and success.

Pediatric interventional radiology: Children’s Healthcare of Atlanta

  • Patient safety is more complex in pediatric IR

    The effects of radiation exposure are much more pronounced in children than adults, making dose management equipment even more important. Additionally, to safely sedate children, IRs depend on anesthesiologists. CHOA collaborates closely with their anesthesiology group, which provides one physician per day to the department to assist in all procedures.

  • Pediatric IR is a largely underserved market

    CHOA has seen rapid growth for the past two years, and expects to nearly double volumes this year when they hire their second full time pediatric IR. The lack of knowledge in the pediatric community, by both physicians and parents, about IR often delays treatment until patients are older and can undergo IR procedures.

Progressive radiology group at large health system: Charlotte Radiology

  • Co-locating IR clinic and suite space improves IR productivity

    Charlotte placed their clinic space directly next to procedure rooms at Carolinas Medical Center. Having the clinic in close proximity to the IR suite allows IRs to see patients in clinic during the downtime between procedures.

  • Placing the IR clinic within the hospital also reinforces that IRs are patient-facing clinicians

    The second reason Charlotte located their clinic within the hospital was to remind referring providers and hospital administrators that IR can play a patient-facing role in care. The physical hospital presence helps IRs demonstrate their value both as proceduralists and clinicians.

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