Part 3: Hospitals Need Product Managers-The Radiologist

Earlier this week I posted Part 2 in a Series Called “Health Systems & Hospitals Need Product Managers: Cancer.

I highlighted that 1 of the 3 insights I gained from interviews & research was the importance of the “TEAM” in the care for patients diagnosed with cancer.

We mapped out how patients were currently being cared for in the community. We took the time to identify all of the key members of the team producing care for patients with cancer. We realized that there are 2 major team members that are responsible in identifying if a patient has or does NOT have cancer, the pathologist and the radiologist. So let’s focus on radiologists today…

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We spoke to patients, family members, medical oncologists, radiation oncologists, surgeons, pathologists, radiologists, family practice physicians, nurses, social workers, schedulers, and many other team members. In the output of the discussions we noticed how many team members depend on the information from the radiologist to make a decision.

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In order to make the best decision on the type of care a team member was going to produce, they needed to understand the location, the extent, potential complications due to adjacent structures, metabolic activity, changes from baseline or previous images, and tissue.

In simple terms, physicians and team members needed a map, directions, a start and stop location, and anything else that may impact the journey of a patient.

Behind the scenes, we saw a lot of reports sent between team members. There were a lot of phone calls. In some cases there were face to face discussions. There were email exchanges. (of course only behind firewalls and with strict safety and privacy protocols) There were internal mechanisms such a tumor/cancer conferences, multidisciplinary meetings, and other review meetings where team members would converge. They could get in a room and discuss the images, the map, and best next steps.

There was also a gap.

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When patients were being informed about being diagnosed with cancer, it was typically a primary care physician, a medical oncologist, or a surgeon. We observed that images may be shown in some instances. However the stories being shared by one of the above team members was more like Cliff-Notes. It wasn’t the same level of meaning as when we heard it being told from a radiologist.

Another epiphany.

Many people do not remember all of the words being spoken during a conversation. Most people do not read all of the information that is given to them. People do remember pictures. People do remember the stories associated with images.

So why not have radiologists speak to patients?

When we began to circulate the idea we heard some of the following:

  1. Why would a radiologist want to talk to a patient? Or to my patient?
  2. Radiologists do not like to talk to patients.
  3. We do not talk to patients since they are cared for by another physician such as family practice, internal medicine, or a specialty physician.
  4. I thought the surgeon and medical oncologist “read” my X-Ray or CT Scan.
  5. Our performance metrics are based on the number of exams we do in a day, and speaking to patients would hurt our measurement.

We worked with team members such as referring physicians and nurses, to administrators and practice managers. We worked with the radiologists.

The result was that more and more patients began to know the radiologists. They began to form a relationship. It decreased the number of appointments that were canceled, rescheduled, or missed. It decreased the number of repeat exams or wrong exam being performed. It sped up the time to get an answer for a patient on whether or not they have or do NOT have cancer, and the next steps.

It increased the communication between the internal team members. It led to increased referrals, better metrics on the performance of the radiologists, and to priority status with radiology benefit managers.

It moved from being a department all about scary technology to a member of the team that tells a story. A story filled with amazing pictures from inside the body.

We brought radiologists out of the dark, and into the light.

The story of imaging needed to be told by the authors themselves. The radiologist.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek

~CancerGeek

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3 responses to “Part 3: Hospitals Need Product Managers-The Radiologist

  1. In my kidney cancer world, it is unusual even to know the name of the radiologist, and most patients rely on his report, as given to the doctor. Many kidney cancers are “incidental findings” on CTs given with another diagnosis anticipated, broken rib, for example. Thus, it is the radiologist who recognizes the cancer long before either the doctor or patient. It may be a metastases that is found, with the primary tumor not yet imaged, or vice versa. If the tumor is relatively small, and no mets are seen in that initial scan, most patients are assumed to have localized disease. Often there are sudden plans for surgery, but not necessarily to search for other distant mets. The patient is likely to be told, “I got it all.”
    However, a good radiologist will know that small primary tumors can also have produced distant mets. That radiologist must also recommend that additional imaging be done in such cases. Too often that small, overlooked met in the lungs or on a bone can go unnoticed for months or years. Only the radiologist can provide a complete understanding of the extent of the cancer, and only with imaging outside the area of the “incidental finding”. He is the first line of defense, and often the first real expert in determining the extent of the disease. Thanks to those unsung heroes!

  2. I would love to meet all the members of my team, not just the onc doc and his PA. And the radiology techs that perform the imaging. You’re right, I don’t even know the name of the radiologist unless I see his/her name on the report.

  3. Pingback: Part 5: Hospitals Need Product Managers-Surgeons | CancerGeek

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