VBHD course blog

Junzi Shi MD

Resident in BWH Radiology Diagnostic

PGY-5

02/09/2020

Speaker from Cleveland Clinic at Value Based Healthcare
Delivery Course

The value-based healthcare delivery course at HBS was a great exposure to the concept of delivering care in an innovative arena. As a radiologist, I am interested in optimizing the workflow and operations of a high capacity, high turnover operation. While radiologists do not participate in primary patient care, we help manage and coordinate patient care and are frequently consulted by other physicians.

Some of the overarching challenges of radiology include how to unite a decentralized operation, streamlining efficiency of a system with fast turnover, billing and coding of various exams, and how pricing of radiology exams can be incorporated into the main hospital stay. Can imaging exams be incorporated into bundled payments in a fair way? Some of the questions with bundled care, as seen with the HBS cases that were discussed, include: how do we differentiate the different levels of patient care? How can the system account for expected waste in an academic tertiary hospital? How can we build in room for complications which may require costly revisions and repeated episodes of care? These are all questions that I am interested in considering after the VBHD course.

As part of my senior elective, I have helped to design a leadership and healthcare business track within the radiology residency program. The VBHD course helped to shed new light on topics such as department operations and strategy from a birds-eye healthcare view as well as the corporate perspective. I particularly enjoyed learning from the interviews with organizational leaders after each case. In some instances, executives listened in the back of the room and came to the front to answer questions afterward. I was impressed with the quality of teaching and the variety of cases discussed.

“Value-based” is the other coin of maximizing profit while doing less. The health system is getting squeezed so that we have to do less, while taking care of more patients. The elephant in the room is how can we make sure the goals of being a physician are aligned with new cost-cutting, value-based initiatives. As part of my ongoing work, I plan to develop a “Business of Radiology” curriculum that will be integrated into the residency curriculum. Ideally a year-long lecture series, the curriculum will cover the fundamentals of strategy, finance, operations, and business culture in hour long conference sessions. I am interested in writing my own business cases and designing an interactive session for students. I’m thankful for attending the VBHD course and getting inspired to learn more about the business side of healthcare.