Economics of MRI Operations After Implementation of Interpersonal Skills Training

Abstract

Purpose: Examine the cost of MRI operations before and after implementation of interpersonal skills training to reduce unanticipated patient-related events in an academic medical center.

Methods: Teams at four MRI sites (two hospital-based, two freestanding) were trained in evidence-based communication skills in February to April 2015. Training was designed to enable staff members to help patients mobilize their innate coping skills in response to any distress they experienced during their MRI visit. Data were collected before training and afterward from January to June 2016. Staff reported the incidence of disruptive motion, sedation use, MRI delays, incomplete examinations, and no-shows. Cost and revenue associated with MRI operations and staff and physician costs were estimated using Medicare and private insurance rates and data from the US Bureau of Labor Statistics.

Results: The study included 12,930 outpatient MRI visits. From baseline to follow-up, average monthly patient volume increased from 1,105 to 1,463 at hospital MRI sites and from 245 to 313 at freestanding MRI sites. Patient factors necessitating sedation or interfering with image progression or quality decreased from 9.0% to 5.5% at hospital sites and from 3.1% to 1.2% at freestanding sites. These changes translated into a reduction in operational costs of $4,600 per 1,000 scheduled patients and an increase in profit of $8,370 per 1,000 scheduled patients in hospital MRI sites, and a corresponding increase in operational costs of $1,570 per 1,000 scheduled-patients and an increase in profit of $12,800 per 1,000 scheduled patients in freestanding MRI sites.

Conclusions: We found significant improvements in MRI operational efficiency after interpersonal skills team training, which were associated with reductions in costs and growth in revenue.

Keywords: Cost; MRI; communication; economics; equipment utilization; interpersonal skills.

Conflict of interest statement

Conflict of Interest:

Elvira Lang, MD: Founder and President, Hypnalgesics, LLC

Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Clinical decision tree for patients referred for MRI: Patients may keep or miss their appointments and face different likelihoods of MRI study completion and treatment with sedation. (1), (2), and (3) represent probability nodes and the (+) sign represents clones of these nodes

Figure 2

Frequency of Events Affecting Throughput. H = hospital-based MRI, F = freestanding MRI facility. Pre = prior to interpersonal skill training, Post = after interpersonal skill training