Integrating a Community Hospital-Based Radiology Department With an Academic Medical Center

Croft, Cheryl R.; Dial, Richard; Doyle, Gary; Schaadt, Jennifer; Merchant, Linda J.

doi:10.1016/j.jacr.2015.07.026

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…For the AHC, partnerships with a CHC allow for enhanced opportunities to interact more tangibly with the community patient population and expand and diversify patient pools for translational research and clinical trial enrollment; partnerships also increase the ability of AHCs to mitigate outcomes and patient access disparities [ 41 ]. Multiple examples of successful CHC/AHC partnerships exist; they serve as models for the feasibility and potential future CHC/AHC partnerships [ 42 , 43 , 44 ].…”

Section: The Emergence and Evolution Of The Community Health Care mentioning

confidence: 99%

The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations

Melas

Subbiah

Saadat

et al. 2020

JCM

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Recent public policy, governmental regulatory and economic trends have motivated the establishment and deepening of community health and academic medical center alliances. Accordingly, community oncology practices now deliver a significant portion of their oncology care in association with academic cancer centers. In the age of precision medicine, this alliance has acquired critical importance; novel advances in nucleic acid sequencing, the generation and analysis of immense data sets, the changing clinical landscape of hereditary cancer predisposition and ongoing discovery of novel, targeted therapies challenge community-based oncologists to deliver molecularly-informed health care. The active engagement of community oncology practices with academic partners helps with meeting these challenges; community/academic alliances result in improved cancer patient care and provider efficacy. Here, we review the community oncology and academic medical center alliance. We examine how practitioners may leverage academic center precision medicine-based cancer genetics and genomics programs to advance their patients’ needs. We highlight a number of project initiatives at the City of Hope Comprehensive Cancer Center that seek to optimize community oncology and academic cancer center precision medicine interactions.

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Section: The Emergence and Evolution Of The Community Health Care mentioning

confidence: 99%

The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations

Melas

Subbiah

Saadat

et al. 2020

JCM

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Section: Description Of the Problemmentioning

confidence: 99%

“…As a response to these changes, academic health care systems are seeking care coordination and system integration. For radiology practices, this evolution has resulted in mergers and partnerships between traditional academic radiology departments and community practices [1][2][3][4].In 2014, a large academic radiology department in the Southeastern United States integrated an existing community practice into a new Division of Community Radiology. The division was created to meet both the inpatient and outpatient imaging needs of a large neighboring city.…”

mentioning

confidence: 99%

Creating a Community Radiology Division: An Academic Radiology Department’s 3-Year Experience

Boyse¹,

Paulson²

2018

Journal of the American College of Radiology

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PROBLEMThe US health care system is evolving rapidly with an emphasis on value-based care and management of populations. There is an increased expectation for improved patient outcome and service. As a response to these changes, academic health care systems are seeking care coordination and system integration. For radiology practices, this evolution has resulted in mergers and partnerships between traditional academic radiology departments and community practices [1][2][3][4].In 2014, a large academic radiology department in the Southeastern United States integrated an existing community practice into a new Division of Community Radiology. The division was created to meet both the inpatient and outpatient imaging needs of a large neighboring city. This brief communication describes our experience as one example of an academic radiology department's effort to develop an effective community radiology strategy.Our health system had previously purchased a community hospital in a large neighboring city. The acquisition was part of a health system strategic plan to expand services in the city's rapidly growing health care market [5]. Starting in the mid-2000s, the health system began to transition the 186-bed community hospital from community medicine to subspecialty medicine with a focus on oncology, neuroscience, and orthopedics.The community hospital was historically served by a six-member, hospital-based radiology practice. As the hospital moved to more subspecialized care over the ensuing years, however, the legacy group had difficulty providing sufficiently subspecialized imaging interpretations. For example, oncologists demanded disease-focused staging information. With the opening of a stroke center, neurosurgeons required increased neuroradiology expertise and availability. Breast surgeons insisted on fellowship-trained breast imagers for consultations.In interventional radiology, the existing radiology practice could not meet the hospital's need for coverage and expanded services. Because of the lack of 24-7 interventional coverage, the hospital was forced to limit interhospital transfers of patients with bowel hemorrhage. Urologists were reluctant to perform partial nephrectomies without interventional radiology backup. New oncologists demanded increasingly complex biopsies and new therapeutic interventions.There was also a health system need for an ambulatory radiology strategy and presence. To compete in the neighboring city's market, the health system's strategic plan called for a rapid outpatient expansion with dozens of new primary care and specialty providers located within multiple new distributed facilities. This provider growth would necessitate a concomitant substantial expansion of outpatient imaging services.Our academic radiology department has long been committed to its missions of teaching and research, but it has not historically been focused on clinical growth in the surrounding communities. The shifting health system goals and local inpatient clinical pressures made it clear that the acade...

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“…Radiologists in this environment are likely to experience downstream effects that affect departmental strategic initiatives, capital purchases, hiring and recruiting, compensation, and teaching and research opportunities. Radiology leaders will need to anticipate and respond to challenges related to asset management, standardization of protocols and processes, and IT within the merged radiology department [25].…”

Section: Enterprise Approachmentioning

confidence: 99%

“…Cultural incompatibility can be a dominant reason for merger failure, particularly when merging academic and private practice radiology groups [23,25]. Potential exists for both vertical conflict (individual physician versus new merged group culture and business model) and horizontal peer-to-peer conflict (academic versus private practice radiologists), both ultimately producing inconsistent and ineffective business practices [24].…”

Section: Culturementioning

confidence: 99%

Academic Medical Centers and Community Hospitals Integration: Trends and Strategies

Fleishon

Itri

Boland

et al. 2017

Journal of the American College of Radiology

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Academic medical centers are widely recognized as vital components of the American health care system, generally differentiated from their community hospital peers by their tripartite mission of clinical care, education, and research. Community hospitals fill a critical and complementary role, serving as the primary sites for health care in most communities. Health care reform initiatives and economic pressures have created incentives for hospitals and health systems to integrate, resulting in a nationwide trend toward consolidation with academic medical centers leveraging their substantial assets to merge, acquire, or establish partnerships with their community peers. As these alliances accelerate, they have and will continue to affect the radiology groups providing services at these institutions. A deeper understanding of these new marketplace dynamics, changing relationships and potential strategies will help both academic and private practice radiologists adapt to this ongoing change.

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Integrating a Community Hospital-Based Radiology Department With an Academic Medical Center

Cited by 6 publications

References 3 publications

The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations

The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations

Creating a Community Radiology Division: An Academic Radiology Department’s 3-Year Experience

Academic Medical Centers and Community Hospitals Integration: Trends and Strategies

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