Author: Natasha

Progress in medical science can be painful.  It’s no joke.  Technology such as PACS and digital imaging can cause repetitive strain injuries for radiologists.  And that’s just the beginning.

Radiology workstations designed ergonomically can help decrease the frequency and severity of repetitive strain injury.  Use of ergonomic principles can vary from simple changes to equipment that changes the way radiologists work and eliminates the cause of many injuries.

You’ve heard the term for several years now.  But what exactly is an ergonomic workstation, and how does it make things better?

Let’s start with the basics.

What is an ergonomic approach?

Almost every activity involved in a radiologist’s job can lead to some type of repetitive injury.

As a radiologist today, your job includes:

• Viewing high contrast images in a dark environment multiple hours per day
• Utilizing speech mics with Speech recognition software
• In certain cases, performing procedures
• Reporting test results
• Preparation of lectures and presentations
• More commonly, these tasks are being performed at home or from teleradiology workstations.

This is just a brief list of activities performed requiring repetitive motions.

Ergonomic workstations are designed to minimize the need for and impact of repetitive motions such as standing, bending, twisting, and leaning in performing your job.  Once these stressors are minimized, you can be more comfortable and productive when working.

What does an ergonomic workstation look like?

Ergonomic equipment for workstations varies by profession.  As it relates to radiology workstations, ergonomic equipment includes:

• Desks/tables that have:
  • Sit to stand adjustment capability
  • Ability to change monitor height independent of worksurface
  • Ability to easily and quickly change focal depth of monitors
  • Large usable worksurface to provide space for radiologist’s equipment: multiple keyboards and mice, voice recognition mic, trackball, etc. . . Ideally a single surface to maximize useable space in a given footprint
  • Ability to be quickly and easily adjusted/set up for each radiologist using the station
  • Dimmable back lighting to reduce eye strain
  • Electric sit to stand workstations/desks
• Monitors that:
  • Meet ACR and FDA standards for brightness and resolution, ensuring images are DICOM Calibrated for proper diagnosis
  • Include productivity tools with the ability to dim worklist panels, limiting ambient light causing eye strain.  Cursor wrap functions eliminating continuous scrolling over the worksurface
  • Maximize viewing clarity from various angles
  • Reduce stress by offering adjustable height and angle
• Chairs that provide
  • Vertebral support
  • Head support

What should you consider before implementing an ergonomic approach at your radiology practice?

Implementing an ergonomic approach is more than buying equipment that has a list of features.  It is important to see how specific features impact your patient care, medical staff, and overall satisfaction of the team.

A comprehensive ergonomic workflow rollout address every aspect of the practice and includes proper training on the use of the equipment as well as how can prevent injuries.

Technicians in radiology can benefit from an ergonomic approach as well.  Important areas to consider for these team members includes:

• Manipulation of equipment necessary for performing procedures
• Transportation of the equipment
• Sit/stand desks for MRI and CT technicians
• Positioning of patients for completion of the procedure
• Ergonomic seating

How Does an Ergonomic Workstation Help Your Practice?

Ergonomics offers more than physical benefits. It results in increased productivity and efficiency, increased accuracy of reporting, a comfortable work environment, improved employee retention, and improved patient care.

The Association for Talent Development¹ indicated that there are several factors that are improved when you focus on health and wellness:

• absenteeism
• retention and turnover
• productivity
• employee engagement

The costs associated with these factors is not small.

When an employee is injured, employers pay for more than the worker’s medical treatment. In its “NSC Injury Facts 2017,” the National Safety Council (NSC) calculates the average cost of an injury at $31,000².

Radiation therapists appear to be at considerable risk for work-related musculoskeletal injuries, which corresponds with findings of studies on health care employees. They are reported to have a high prevalence of injuries (76%)³.  In fact, 58% of radiologists report symptoms of repetitive stress injury (many spend over 8 hours per day at their desks).

The most common site-specific injury is the lumbar back, followed by the neck and shoulders³. Other injuries can include repetitive stress injuries, visual problems, and headaches.

Productivity and Efficiency

When an ergonomic approach is used, staff can avoid bending, twisting, and awkward positions that cause fatigue, soreness, and lost time, as well as decreased comfort as the workday progresses.

Employees can be happier and have more energy when they can be comfortable when they work.  It’s easy to see that more energy put into helping patients results in patients who are happier with the care they receive.

Accurate Data Entry: A Surprising Benefit

Initially you might not consider that an ergonomic approach to Radiology workstations could impact the accuracy of data entry.  However, consider that you would have a higher level of fatigue throughout the day when you have a high level of stress on your body. Errors are more likely due to the higher level of stress and fatigue that results in decreased focus.

Ergonomic equipment increases safety and comfort throughout the day, meaning that employees are safer, more comfortable, and less fatigued.

A Comfortable Radiology Workstation adds Value and Savings

When care providers can adjust table height, view records through an optimally sized and correctly positioned monitor, and move easily around the facility/unit, they are more comfortable and experience less fatigue. This means that strain on backs, wrists, and necks is drastically reduced, or eliminated.  Ergonomic workstations designed to the unique demands of a job helps the radiology team do their job effectively and efficiently in comfort.

A ROI Comes in Many Forms

By now you realize that implementing an ergonomic approach requires investment of time and money.

Considering the costs of worker’s compensation, rehabilitation, and training of new radiologists, it is easy to see how you can quickly realize a return on your investment.

The biggest savings are seen in:

• Less time off for injury
• Fewer staff injuries and worker’s compensation claims
• Greater accuracy in reporting and patient care
• Healthier and happier staff with less turnover

When preventable injuries, burnout, and staff error are avoided, money typically spent on these items can now be spent where it is needed most.

Improved Patient Care is the Ultimate Reward

Imagine the improved patient care and improved patient satisfaction when:

• Procedures are completed once because the staff could effectively and efficiently do it correctly the first time
• Appropriate care is provided because errors are not made that might be related to fatigue or limited focus
• Patients are more confident in the services they receive because staff treating them are more positive and energetic when providing care

These are just a few ways that an ergonomic workstation can improve patient care.

Why You Should Work with Double Black Imaging for Your Radiology Workstations

At Double Black Imaging, we don’t just sell you equipment to meet a standard ergonomic need.  We complete an onsite radiology workstation survey to assess what ergonomic equipment will be best for you and your radiologists.

We make specific recommendations for each surveyed workspace.  Our recommendations for your specific needs are based on our insider knowledge of PACS, mammography/tomography, clinical and surgical applications.

Contact us here, email us, or call us at (877) 852-2870, to arrange your Onsite Radiology Equipment Survey and determine what workstation will be best for you and your radiologists.

 

References:

1. ATD Releases 2016 State of the Industry Report | ATD, January 9, 2023
2. Employee Injuries: What Is the Real Cost to Employers? (workplacetesting.com), January 9, 2023
3. Prevalence of Musculoskeletal Work-related Injuries Among Radiation Therapists – PubMed (nih.gov), January 9, 2023 Hanania AN, Cook A, Threadgill MP, Conway SH, Ludwig M. Prevalence of Musculoskeletal Work-related Injuries Among Radiation Therapists. Radiol Technol. 2020 May;91(5):414-421. PMID: 32381659.

No Surprises Act in Radiology: A Summary of Key Factors

What is the No Surprises Act in Radiology?

 

When treated by facilities or physicians outside their insurance network  patients could receive large, unexpected bills. This is known as surprise billing.

Simply stated, these providers do not participate in an insurance plan and typically bill and are reimbursed at a different rate.

The No Surprises Act is a federal law that limits the financial obligations of patients to out-of-network providers. This applies to emergency and non-emergency situations.

No Surprises Act billing rules state that a patient’s out-of-pocket expenses should be the same for out-of-network providers as it is for providers in-network. Depending on the patient’s insurance plan, this will be the co-payment, co-insurance, or deductible that is normally owed to in-network providers.

 

When was it voted on?

 

In December 2020, Congress signed the Consolidated Appropriations Act.  The No Surprise Act is part of that legislation.

 

When did it go into place?

 

The No Surprises Act effective date was January 1, 2022, so you are now expected to follow the law.

 

What has changed because of this act?

 

If your state has already enacted no surprise billing legislation, the No Surprises Act will not supersede it.

For states that have not yet enacted a surprise billing law, the No Surprises Act will result in several changes.

For non-emergency care, you will need to obtain consent prior to providing services.

Secondly, the patient cannot be billed directly.  You will need to bill and negotiate reimbursement through the insurance provider.

Once you have received payment, you have 30 days to negotiate or appeal the amount.

Finally, you will need to use the established system to negotiate and/or request arbitration of reimbursement rates.

 

Services Covered

 

If a patient requires emergency care, you should provide services until they are stabilized.  As an out-of-network facility, you must then address the issue with the patient to obtain consent to be transferred to an in-network facility or physician.

The patient can also consent to continue receiving out-of-network services from you.

Patients who sign consent waivers will then be responsible for the balance of uncovered expenses.

In a non-emergency situation, if your facility has in-network providers, you are permitted to request a consent waiver.  This allows you as the provider to balance bill the patient.

In these non-emergency situations, it is important to note that you need to give the patient a written consent waiver 72 hours prior to the procedure/medical service.

You need to include the following in the consent waiver:

1. A declaration that you are not in the patient’s insurance network
2. An estimate of the cost of your services that is as accurate as possible
3. If your facility is in-network, a list of in-network providers at your facility
4. A summary of any prior authorization or care management requirements that must be in place prior to the procedure/service
5. A statement that the patient can opt to receive care from an in-network provider

When the non-emergency procedure will occur in less than 72 hours, you must provide the notice/consent waiver at the time the appointment is made.

 

Independent Dispute Resolution (IDR)

 

The No Surprises Act provides a system for negotiating reimbursement.  Please note, you only have 30 days to come to a resolution with the payer or to file a dispute if you cannot come to an agreement.

If you fail to reach an agreement with the payer, you or the payer have four days to activate the Independent Dispute Resolution (IDR) system.

Once the IDR is initiated, you and the payer will each submit an amount to an arbitrator, who will select one of those amounts as the settlement.

You cannot split the difference or request further negotiation.

Once decided, neither you nor the payer can repeat the process for the same service or procedure with each other for 90 days.

The losing party pays the cost of the arbitration process.

Over time, you will learn what level of payment is acceptable to the arbitrator, and this should limit the need for IDR appeals.

 

Impact on Radiologists

 

Radiologists and other ancillary service providers are not able to use consent waivers. This means you must abide by the in-network payment policies of the Act.

The No Surprises Act does not exempt patients from financial responsibility. You can expect them to pay what they would pay if you were in-network. This will be clearly communicated to you on the Explanation of Benefits (EOB) that the insurance company sends with their payment to your practice. You can bill the patient for this amount once you have accepted the payment or a payment has been negotiated. You can bill them for their co-payment, co-insurance, or deductible as indicated in their insurance plan.

Time and resources spent negotiating rates and engaging in arbitration, will impact finances for you and the payer. It is in your best interest to establish a system to minimize this impact.

One solution is to try to reach an agreement with out of network (OON) payers. This will eliminate potential disputes about reimbursement, special claim handling and costs of arbitration via IDR, so it will be beneficial to them to make this agreement with you.

 

Importance of developing an internal process

 

You will learn about the charges and reimbursement for OON patients as you settle disagreements with the payer.  However, handling charges for these patients will require a different system than what you use for in-network billing.

Be sure in-network vs. out-of-network status is clearly determined from the beginning for these patients so their reimbursement claims can be processed correctly.

Even though patients are out-of-network, you should submit your initial claim to the insurance company for your full fee.

Your system should tag accounts so that you can review payments when they are received.  This will avoid billing the patient for the balance rather than the allowed amounts.

You also want your staff to determine whether the payment is acceptable to your practice within the 30-day negotiation window.  This way, you don’t miss the opportunity to negotiate a rate or file a dispute.

Your staff can respond quickly and know if negotiation is necessary. If you take the time to create a list of reimbursement rates that you find acceptable for your procedures. Also, over time you will learn from the arbitrator what is an acceptable reimbursement level.

Claim processing can be more efficient if you create a fee schedule within your accounting system.

 

About Double Black Imaging

 

Since 2002, Double Black Imaging has brought high quality computing and imaging products to the market in response to changes in the market technology and medical care. We offer solutions that will help you implement these changes effectively and with minimal effort.

Contact us today at (877) 852-2870 or email us at sales@doubleblackimaging.com to learn more about how our products can help you comply with these new requirements without a negative impact on your budget.