Radiology Associates

Sustained Performance Above National Benchmarks With a Button-Based Workflow

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Background

Diagnostic imaging volume in the United States continues to grow while the radiologist workforce remains limited. National projections show increased utilization of CT and MRI, yet fewer than 32,000 radiologists are available to interpret the corresponding studies. Even small workflow inefficiencies affect access to care, turnaround time, and the well-being of clinicians who already operate under intense demands.

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For many decades, radiology reporting has depended on spoken dictation. Although speech recognition systems have improved, they still require radiologists to repeat phrases, correct transcription errors, and spend time restating observations that are already clear on the image. These interruptions have nothing to do with clinical expertise and they reduce the time available for interpretation.

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At Radiology Associates of San Luis Obispo, documentation became a limiting factor. Reporting was slow, not because studies were complex, but because dictation forced radiologists to waste time saying and repeating what their eyes had already diagnosed. This was not a performance issue. It was an inefficiency created by the reporting method itself. Rising imaging volume pushed the group to consider alternatives that could increase throughput without altering clinical judgment or adding staff.

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The Need for a Better Method of Reporting

RASLO serves hospitals and outpatient centers across California’s central coast. As in many regions of the United States, the number of examinations increased steadily in the years preceding this study. National trends show that CT and MRI use has risen by approximately 20% on a case-mix adjusted basis over the past decade.

 

Traditional dictation created delays that affected the entire care cycle. Radiologists interpreted studies efficiently, but documenting the findings slowed the process. Speech recognition errors required extra time. Inconsistent phrasing created variation among reports that complicated communication with referring clinicians. Billing teams encountered differences in terminology that made coding more difficult.

 

RASLO did not need a tool that changed how clinicians read images. It needed a system that removed friction from the process of communicating what had already been determined.

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Adopting a Button-Based Structured Reporting Platform

RASLO implemented TurboRad, a template-based structured reporting platform that replaces most spoken dictation with standardized text elements called TurboButtons. Radiologists select findings using organized clinical options that reflect relevant normal and pathologic findings. The system builds complete reports using consistent language that aligns with national standards while allowing radiologists to edit or dictate whenever they choose.

 

TurboRad does not interpret images and does not restrict clinical autonomy. It removes the mechanical burden of verbal repetition. Radiologists spend more time evaluating studies because they spend less time constructing sentences.

 

The platform supports the clinical workflow by:
 

• Standardizing language and report structure

• Reducing corrections and proofreading

• Limiting time lost to repeated dictation

• Making documentation fast without limiting judgment

 

Documentation quality improves without requiring radiologists to speak every detail. The interpretation remains entirely in the hands of the physician.

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Methods

A retrospective review was performed to measure productivity after the implementation of TurboRad at RASLO. Twelve radiologists were included. Annual wRVUs were collected from billing cycles through Quinsite and were de-identified before analysis. To calculate daily productivity, data were normalized to 170 clinical days per year. National averages were based on a benchmark of 10,500 annual wRVUs, a mid-range estimate selected due to limited public access to paid datasets. This benchmark is consistent with published industry expectations for diagnostic radiology. Interventional radiologists were included in the dataset. They typically produce fewer wRVUs per day because procedures require more time than diagnostic interpretation. Including these clinicians strengthened the analysis by presenting a realistic group average

 

Results: 

Over the three-year study period, the RASLO working group demonstrated higher average annual wRVUs per radiologist in comparison to the national average based on data collected from billing cycles. The average annual wRVUs per RASLO radiologist was 19,851 in comparison to the national average of 10,500.9,10

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Average annual RASLO wRVU by group. 

2022 - 19,295

2023 - 20,865

2024 - 19,393

In 2022, RASLO radiologists recorded an annual average of 19,295 wRVUs, exceeding the national benchmark of 10,500 wRVUs by 8,795 (Table 1). This represents 1.84 times the national average. The performance increased in 2023, with the RASLO annual wRVU average climbing to 20,865, 10,365 wRVUs higher than the national average, corresponding to 1.99 times the benchmark. This reflects a year-to-year increase of 1,570 wRVUs for the RASLO group. In 2024, RASLO average annual wRVUs declined to 19,393, yet remained higher than the national average. This difference of 8,893 wRVUs corresponds to 1.85 times the national average. The decrease from 2023 to 2024 represents an average reduction of 1,472 wRVUs per physician. Across the study period, RASLO radiologists maintained annual wRVU levels that were 84% to 99% above the national average. There was variation across the annual wRVUs in the RASLO working group across the three-year period (Figure 1 & Figure 2). The highest relative difference was in 2023, when RASLO annual wRVU output was nearly double the national benchmark. Although RASLO workload decreased in 2024 relative to the prior year, the difference remained substantial compared to national peers, indicating a consistent trend of elevated workload and productivity.

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Figure 1. Annual wRVUs per radiologist in RASLO group 2022 – 2024.

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