Economies of scale between competitors
Four Washington health-care providers were facing a problem. Harrison Medical Center (Bremerton), Advanced Medical Imaging (Silverdale), The Doctors Clinic (Silverdale), and Olympic Radiology (Bremerton), all separate, multisite organizations located on the Kitsap Peninsula, west of Seattle, knew that having competitors was creating problems for patients. For instance, it was not uncommon for a patient to be imaged at another facility before being admitted to Harrison Medical Center’s emergency department, but there was often no way to access that patient’s prior studies, even if the on-call physician knew which facility held them.
The four organizations decided to come together to look for a solution. In a conversation initiated by Adar Palis, executive vice president, CAO, and COO at Harrison Medical Center, they addressed both their competitive concerns and their desires to improve care. “Everyone agreed to come together for the best interests of the patients,” Palis recalls, “and we quickly realized the incredible financial benefits that we could achieve by working together. The idea communicated to the group was simple: We are all in this business to provide the best care possible, but let’s look at providing it more economically.”
With this in mind, in September 2012, the four organizations created Northwest ImageShare by taking advantage of Harrison Medical Center’s Sectra PACS. It includes sophisticated, unique image-sharing algorithms. Advanced Medical Imaging was also using the Sectra PACS at that time; the other two organizations recently converted to using it. Sectra’s cross-platform worklist technology securely partitions each entity’s information in the archive, in compliance with HIPAA regulations—but when a patient changes providers, the new provider is able to access the entire relevant patient folder of images and reports. To maintain the referring base’s privacy, all references to the physician’s name and information are invisible to the viewing entity.
Harrison Medical Center hosts the data center and the archive for the entire group. In lieu of a fee per exam paid to the PACS vendor, Harrison Medical Center collects the fees; these, taken as a whole, constitute less than half what the other three organizations were previously paying for their PACS platforms. With the fees assessed in this way, the more exams that are fed into the Harrison archive, the less each exam costs the providers, creating further economic incentives for participation. Brennan Dobbins, clinical and ancillary services director for The Doctors Clinic, states, “With Northwest ImageShare in place, our PACS costs are reduced by 60%. Decreased per study storage costs, along with support-staff reductions and the absence of an on-site archive, compose the savings.”
Looking forward, the organizations hope to expand the project to include other Seattle-area providers, taking further advantage of economies of scale while making care even more comprehensive for patients in the community.
Excerpted from an article by Cat Vasko