Although there is high demand, many health professionals are not able to or legally allowed to provide healthcare to patients as the coronavirus pandemic seizes more facets of normalcy and social distancing protocols keep extending.
The condition of doctors who are on the frontlines of the current health crisis is as close as a situation it gets to a fire station being burned down.
But where there is a necessity, there most likely births invention.
The fallout from the respiratory illness COVID-19 has not stopped Collaborative Imaging, a North Texas-based collective of doctors, from continuing to provide critical healthcare services. The alliance’s more than 400 radiologists are staying at home and serving patients in hospitals across the country.
Historically, a typical radiology room has about six radiologists working in close contact with each other who are reading studies or medical scans.
“We realized by having them all in a concentrated area, it’s very possible that one of them gets sick or somebody walks into the reading room who is sick,” Collaborative Imaging CEO Dhruv Chopra said. “And, all of a sudden you have the entire workforce getting sick. All the radiologists in the hospital would get sick.”
Collaborative Imaging has developed a proprietary cloud-based radiology reading system. The technological solution can be integrated into a normal computer, be it at home or at a hospital. An embedded messaging capability further facilitate the communication between radiologists, referring physician as well as hospital imaging department personnel and patients.
The process also got a huge boost from President Donald Trump’s declaration of a State of Emergency on March 13 due to the COVID-19 pandemic.
The declaration authorized the Centers for Medicare and Medicaid Services to provide blanket waivers to federal licensing requirements so that out-of-state physicians could treat Medicare and Medicaid patients via telehealth services.
As a result, now, anyone in Collaborative Imaging’s network of radiologists, who are spread across the U.S., can look at a patient’s reading and provide time-sensitive assessments. The company has affiliated offices in locations from the east coast to Hawai, so, effective patient care can be provided from any time zones to any medical facility that requires it.
In essence, the network has become like a crowdsourced platform to find a radiologist. Or, an uber-like version for radiology
Collaborative Imaging has its presence in most major healthcare systems in the U.S. It has about 150 North Texas radiologists who provide services to Texas Health Resources, Baylor Scott & White Health, Methodist Health System, HCA Healthcare among others.
“We brought in the technology and the expertise to be able to transplant the doctors who were sitting at the hospital and have them read from home,” Chopra said. “Nothing is delayed – patient care, reports. Everything continues just as they would, without them being physically there.”
Chopra established the alliance in 2018 in Plano. His initial and prevailing vision, he said, is to support the future of radiology and fight against the consolidation of independent practices by larger firms.
A 2019 study published in the Journal of the American College of Radiology found radiologist practices with fewer than 99 members had decreased considerably in recent years.Whereas, the number of groups with more than 100 members increased by about 6% between 2014 to 2018, the study stated.
“Private equity companies are going around and buying up practices. The younger guys in the practice have now become employees of the company,” Chopra said. “The private equity company exists to increase profit. Now, all of a sudden, their revenues are going down. They are getting paid less. They are having been forced to do more work.”
“Doctors are scientists at the end of the end,” Chopra added. “They are not business people.”
The COVID-19 pandemic may have only added more troubles for such health professionals.
Nashville-based Envision Healthcare Corporation, which provides physician services to more than 1,800 facilities across the country, announced earlier in April that it reduced salaries for senior leadership by 50% and implemented additional salary reductions and temporary furloughs for many of its employees.Envision’s radiology business is also conducting teleradiology similar to that being conducted by Collaborative Imaging.
Envision experienced about 70% decrease in patient volume across some practices and specialties. Emergency department visits were reported to be down by 30%.
“This is a hard situation, because in the places where patients are staying home, doctors have fewer appointments and shifts, and thus reduced revenue,” Envision’s CEO and President Jim Rechtin said in a press release on the company’s website regarding these changes. “Where they lose their normal billing revenue, medical groups are losing money. Where medical groups are losing money, they have to reduce salaries and furlough workers. Unfortunately, we are no different.”
In contrast, Collaborative Imaging runs in a completely different business model.
Collaborative Imaging would invest and manage the day-to-day activities of a healthcare practice. It does not own the practices, which remain independent.
All members of Collaborative Imaging receive equity in the radiologist-owned company. The company also pays out dividends to all the physicians every quarter.
“The consolidators make money on their group, but they never give it back to the people because they are private equity,” Chopra said. “In our world, when [Collaborative Imaging] improve and revenues grow, 100% of the profit goes back to our investors.”
And, the members are making more money, comparatively.
Back in 2018, Texas Radiology Associates became the first major group to join Collaborative Imaging. The radiology service provider has 140 subspecialized radiologists who serve health centers across North Texas.
The practice, established in 1972, was on the verge of selling out. But since joining Collaborative Imaging, its revenues have grown by almost 25%, while operating costs fell by almost 30%.
In total, Collaborative Imaging currently has about 675 service locations and reads an estimated 800,000 exams per month.