MRI

Root Cause Analysis Volume 2018

Root Cause Analysis Volume 2018

With a closing volume of 4,971 scans, it makes for the first year since 2014 that we performed under
5,000 scans. In addition, the year proved unfavorable to our budgeted volume by 255 scans and more
concerning in my opinion, proved an underperformance from 2017 by 168 scans. To lean on the fact
that the deficit was from several physicians no longer practicing in our area was not enough. A root
cause analysis was conducted to help pinpoint the origin(s) of our volume loss, to dissect referral trends
and changes, and to map out a strategic plan to overcome potential volume challenges in 2019.

Physicians No Longer Practicing In Our Area
2018

400
350 337
300
250
200 192
150
100 93

50 23 17 12
0
Hisham Kennieth Mahgoub Shannon Jamie Total Scans
Hakim McCollouth Eltoum Jernigan Chappell

1

Root Cause Analysis Volume 2018

The analysis and action plan will be a moving piece throughout 2019 as I continue to learn more. Data
compares 2017 and 2018.

• Key areas contributing to the decrease in scan volume were from the five physicians that are
no longer practicing in our area and physicians outside our primary market that did not refer
in 2018. These are physicians that sent 1 -2 scans per year. In addition, there were nine key
physicians that decreased in referrals ≥10 scans.

• The graph below shows a 97 scan decrease in referrals from The Craddock Clinic. This is a
strong referral partner and we rely heavily on their business.

• Charles Spellmon is a sports medicine and family practice physician out of Alabaster. We had
people leaving our community/county seeking family and sports medicine care in Shelby
County.

• Corey Gilliland is a pain management physician in Pell City. With the loss of Hisham Hakim,
some have sought pain care elsewhere. Jonathon Moore has taken Dr. Hakim’s place and we
are starting to see more referrals from his office. Gene Gordon is in town and we are starting
to see his business as well.

Referrals Decreased by ≥10 Scans

(Columns highlighted in yellow denote physicians no longer practicing in area)

2018

250 192
200

150 93
100

50 29 25 23 21 20 20 19 19 17 17 12 10

0

2

Root Cause Analysis Volume 2018

• To help offset the decrease we had 96 new physicians that referred in 2018 and these are
usually physicians outside our primary market that send 1-2 scans per year. In addition, some
referring physicians increased their referrals ≥10.

• The graph below shows Dr. Nix as an upcoming contender for making it to the top five on any
given month. He is doubling Dr. Jernigan’s contributions.

• Bryan Wimbish is a sports medicine provider at Ortho Express in Chelsea. His referral pattern
shows that we have patients in our area seeking orthopedic care outside our
community/county. Bryan views us as a trusted healthcare partner and sends those patients
back to us for an MRI. He makes referrals to Dr. Tropeano for surgeries but often cannot get
appointments made. He now sends his surgery patients to groups out of Birmingham. At
least one of our local physician offices are referring out for orthopedic care for much of the
same reason and we are losing those MRI scans.

• E. Vonrottenthaler is a Hematology/Oncology physician out of Pell City. She averaged almost
two scans per month.

Referrals Increased ≥10 Scans
2018

70 59
60
50 49 46 44 43

40 28 27 25 22 22 20 18 16 12 12 12
30
20

10

0

3

Root Cause Analysis Volume 2018

• Top ten referring physicians for 2017/2018 showing a mix of ↓and ↑. These are physicians we
have been able to count on every year. A significant decrease of 103 scans for Dr. Hamo.

TOP 10 REFERRING PHYSICIANS
2017 and 2018

1200 9371040
1000
557498 470480 355380 318272
800
600 201152 167140 156128 104124 120 76
400
200

0

2018 2017

In closing, I hope the data presented gives you some insight into what occurred in 2018 and the dots
that will need to be connected to ensure we are presented with every opportunity to surpass obstacles
and reach goals in 2019. The root cause analysis will allow me to make the best use of my time as
physician visits and content discussed will be strategically mapped out before marketing departures.

Phase I Action Plan
1. Reach out to physician offices that decreased in volume ≥10. What were the

contributing factors? Are the factors inside our control? What improvements can we
make? Extend gratitude.
2. Reach out to physician offices that increased in volume ≥10. What were the
contributing factors? What did we do well as a provider? What can we improve upon?
Extend gratitude.
3. Visit Dr. Spellmon, Dr. Gilliand, Dr. Elkier, Dr. O’Malley and others to understand their
referral decrease and how we can get back on track with those referrals. Extend
gratitude.
4. Review the physicians that referred 1-2 scans and evaluate the opportunities for more.
Make calls/visits where needed.
5. Review the physicians that did not refer at all in 2018 and evaluate if opportunities are
there.

4