UCSD's Matt Costa

Q&A with Matt Costa, lead CT technologist at UCSD Medical Center

May 29, 2013
by Loren Bonner, DOTmed News Online Editor
Data is here to stay, but figuring out how to use it most effectively in health care is on a lot of people's minds these days. Matt Costa, CT manager at the University of California San Diego Medical Center spoke to DOTmed News about how he's able to manage critical data on the use of his facility's imaging systems.

DMN: What are some of the common challenges an imaging manager like yourself is up against these days?
MC: Annual changes in Current Procedural Technology (CPT) codes and billing practices can pose a couple of challenges. My team spends an increasing amount of time doing quality control, ensuring biller coders are updated, reports are addended correctly, and images are up to date in our picture archiving and communication systems. Staffing multiple locations is also a challenge. With the decrease in the number of staff per shift, it becomes particularly important to craft coverage plans for vacation and unplanned sick time.

DMN: Why is having data so important in a facility like UCSD?
MC: Data is critical to understanding the nuances of how the seven scanners and 37 employees I manage work together to perform about 33,000 exams annually. Without a breakdown of which types of scans are occurring on which machines and when, as well as how long patients are on the table for their exams, an imaging manager has no way to recognize timing gaps and utilization patterns ripe for fixing.

For instance, UCSD had an eight-day backlog for outpatients to schedule an exam in early 2012. The radiology information system I was using at the time provided me an overview of scanner activity in my department and on paper showed that the scanners were busy. Data later enabled me to figure out that wasn't the case. Once I gained access to data on what each machine did and when, I recognized that many scanners weren't being used at the times nursing shift changes occurred each day since inpatients were not coming down for scans. Upon realizing scanners were free, I added four outpatient slots for each day.

DMN: Talk to me about the web-based tool that you've begun using: How long have you been using it and what does it help you do?
MC: I began using GE's iCenter in early 2012 after I decided UCSD needed better visibility into scanner utilization. It's a straight-forward, online tool that works behind the scenes to provide me with real-time operational and performance data on UCSD's diagnostic imaging equipment. It didn't require any staff training to use it and immediately brought to light valuable data that helped me to identify the types of small changes that have created savings and greater efficiencies.

DMN: What did you notice immediately from the data? What improvements has it led to?
MC: I can now see in real-time what each scanner is doing. iCenter shows me in graph-form when the patient is on the table and the exact minute that an exam starts and ends. It allows me to physically spot holes when certain machines aren't being used and spot any timing problems or patterns as they arise.

In one facility, I noticed that a scan that normally takes between five and 10 minutes was taking an average of 20 minutes. Using the data from iCenter, I saw that technicians were devoting an extra ten or sometimes 15 minutes to get patients' IVs' started. Knowing that information, I added a nurse to that site to help with IVs. Because of making that small change, the scan times dropped back to between five and 10 minutes.

DMN: Have you noticed that patients are more satisfied?
MC: There have been less complaints about wait times from the patients and the ordering physicians who need the results to schedule follow-ups. Also, our current backlog has been reduced to one or two days compared to the previous eight. We are also comfortably scheduling patients three days after the order is placed to give us time to get pre-authorization.

DMN: Why is workflow so important in health care today, especially imaging?
MC: In a nutshell, workflow is the key to keeping my department open and financially sound. We have many people to accommodate, including patients, ordering physicians, radiologists, and the technologists themselves. Monitoring our productivity and scheduling is directly tied to how well we serve patients, help the ordering physicians to treat them and ensure that our resources are being wisely utilized.

On a broader scale, with an estimated 32 million new patients entering the health care system under the Affordable Care act, it's particularly important that hospitals mobilize to treat the growing volume of patients without sacrificing quality of care. From my perspective, the first step in accomplishing that end is getting critical data about the use of systems to ensure that existing resources -- including physical space, infrastructure, staff, and equipment -- are being used most efficiently.