por John R. Fischer
, Senior Reporter | July 21, 2020
A seven-day total value between April 7 and April 13 confirmed a drop of 55% in total imaging volume. Outpatient settings took the hardest hit at 68%, followed by EDs at 48%, and inpatient settings at 31%. Mammograms and nuclear medicine scans declined the most of all modalities, by 93% and 61%, respectively. Following them were declines in ultrasound (58%); MR (56%); plain films (53%); and CT (47%). "Outpatient studies tend to fall into this category of lower acuity studies that have decreased likelihood of altering clinical outcomes compared to the higher acuity ED and inpatient studies," said Parikh.
The main campus hospital experienced a 42% drop in volume but had less of a loss than the East Hospital at 60% and the West Hospital at 54%. Together, all three recorded a 48% total loss in imaging volume.
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"Knowing that there may be a shift in volumes, decreasing in some areas and increasing in others, we were able to train and repurpose radiology technologists to reach out to patients with outstanding orders to schedule over 10,000 patients for future orders," said Parikh. "There were also staff repurposed to be screeners at doors into hospitals and ambulatory sites, to screen staff and patients for symptoms and temperatures. We also were able to shift technologists from free standing Emergency Rooms that were temporarily shut down due to volumes and use them at other sites where there was more need. This prevented furloughs and lost jobs."
The study also calculated revenue losses, with the Central hospital hitting its lowest point on April 14 with a 49% decrease from its technical component compared to normal practice prior to the pandemic. This coincided with the imaging volume decrease seen around April 13. The numbers are expected to help hospitals forecast demand in various patient settings, should stay-at-home or lockdown orders be declared in Ohio, as well as repurpose staff and change clinical policies before changes in patient volume take place.
Parikh says he and his colleagues have gained a number of insights for addressing volume loss and helping hospitals to recover as they open up once more. Among these tactics are extending patient scheduling calls to evenings and weekends to reschedule postponed exams; partnering with software companies to create virtual waiting rooms and maintain social distancing practices; universal masking mandates; and reducing or eliminating faculty incentive payments including overtime and internal moonlighting, while maintaining base compensation.