Get to know referring physicians to meet their imaging needs

2014 02 03 14 14 42 735 Doctor Woman Happy 200

If you're a radiologist, you know that referring clinicians are your customers, and it's important to keep them happy. What do your referring physicians really want from their radiology reports and interactions with the radiology department? Just ask them, according to researchers from Duke University.

From a series of interviews with top referring physicians, the Duke team gleaned useful insights that led to improvements in radiology customer service, according to Dr. Daniel Boll. He described the project during a session at the recent International Symposium on Multidetector-Row CT (MDCT 2014) in San Francisco.

Voice of the customer

It's important for radiologists to understand what referring clinicians value and how they will utilize radiology reports, Boll said.

"Once you have identified your customer, you can use a 'voice of the customer' approach to extract information directly from them," he said.

The first step in this process is discovery, which involves identifying important stakeholders for your services. In radiology, this can be accomplished by searching the electronic medical record to find the top referrers of imaging studies to the department.

Over a span of 2.5 years, radiologists at Duke conducted 47 qualitative interviews with top referring physicians in an effort to better understand their target customers. Each interview lasted approximately an hour and featured open-ended questions. Participating physicians were from areas including urology, vascular surgery, transplant surgery, cardiology, neurosurgery, gastroenterology, reconstructive surgery, orthopedic surgery, emergency medicine, pulmonology, hepatology, and genetics.

These discussions brought disciplines together and shed new light on the day-to-day challenges radiology customers were facing with their services, according to Boll.

After the interviews were conducted, the researchers gathered key statements from the interviews and converted them into 352 individual customer "voices," or data points on how the radiology service did its job and how it could improve.

Boll and colleagues then categorized each statement as either a fact -- an objective statement describing a customer challenge -- or a feeling -- an emotional statement expressing a customer opinion about the challenge. There were 81 facts and 271 feelings.

While facts are usually relatively easy to address, "feelings are a little bit more difficult, but they can give you perhaps the greatest opportunity to really change the atmosphere and change the entire environment," Boll said.

Anonymized customer quotes were formatted onto place cards and placed on a wall. They were clustered using the Jiro Kawakita affinity methodology into five common theme groups:

  • "We need you to know us better."
  • "We need you to consider our workflow."
  • "We need more from your services."
  • "We want to review your data in certain ways."
  • "We want to do more with you."

"With this clustered affinity approach, you have the right tools to approach the hospital administration, for instance, to justify further investments," Boll said.

The method identified some great opportunities for improvement; for example, some referring physicians commented that they wanted radiology to know them better, he noted.

"It was really an issue of information exchange," he said. "Physicians sometimes said, 'We would love to give [radiology] more information, but we don't have the opportunity to do so.' This can lead to maybe some miscommunication early on."

Based on these comments, the radiology department added the ability for referring clinicians to explain exactly what they want when they're ordering 3D studies, or 2D studies with a 3D component.

The group also decided to continue its interviews of referring physicians on an ongoing basis to make sure that improvements are helpful to them and to determine if any refinements are needed, Boll said. Radiology reports were fine-tuned to ensure that they meet the needs of clinicians.

"By circling back to your clinicians, you make sure there is an ongoing communication," he said.

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