Four Reasons Your Imaging Center is Losing Patients and Money 

Healthcare providers estimate losing up to 20% of revenue due to “referral leakage.”  While it may sound like a medical term, referral leakage occurs when patients are referred to a specialist but either do not follow through with an appointment or seek care from a different provider.  

Imaging centers operate in competitive markets under pressure to build and maintain market share.  Why then, do they allow their patients and profits to leak out through sub-standard ordering processes when modern technology provides a simple solution?  

In the fall of 2023, I needed an MRI due to a sports injury and I learned firsthand why patients often opt out or go elsewhere.   

1. Lack of differentiation 

“Which imaging center do you want to use?” my provider asked as I hobbled toward the front desk.  There were six centers to choose from and I didn’t have a preference. When every imaging center appears the same, there’s no reason for the provider to direct a patient to one over the other. However, what if instead of another frustrating ordering portal or paper form and fax, one of the imaging centers offered fast and simple technology that made it easier for the provider to not only order an MRI, but also to submit clean, complete patient information including “clinicals”? What if this technology made it possible for my doctor and the imaging center to provide better care without huge delays? What if this amazing technology also reduced the number of nagging phone calls to the practice’s front desk seeking additional demographic, insurance, and other information needed for the insurance company to authorize the service? You can bet the question would instead have been, “We tend to use imaging center XYZ because they are efficient at getting patients scheduled. Would you prefer to use them or someone else?”  

2. The Walk-in Option 

“It’s probably going to take 10 business days to get authorization from your insurance company, so make sure not to schedule your MRI appointment until at least 2 weeks out,” my provider recommended.  He had prescribed me an oral steroid to reduce the swelling, but I was experiencing near-immobility and excruciating pain. Moreover, I was worried that my injury might need further clinical intervention.  On my ride home, we passed a random imaging center. I considered dropping in and getting the MRI with cash-pay. I have a high deductible plan, so this was going to be cash out of pocket either way. Sure, my order had been faxed to the other imaging center, but I wasn’t obligated to show up. This time, I skipped the walk-in and went ahead and scheduled my MRI 16 days out to give plenty of time for the prior authorization (“PA”) to come through. Two days before the appointment, I was informed that the PA did not come through and I needed to reschedule. If I hadn’t been out of town at a conference (ironically, a radiology one), I’d have immediately opted for the walk-in. 

3. Patient No-Show 

As the days went by, the steroid was doing its work in reducing swelling.  I was not out of the woods, but my mobility was coming back. I started to think that I might heal on my own. The rescheduling of my appointment was an added annoyance.  Did I really need to spend a chunk of the day and hundreds of dollars for a procedure that looked more likely than not to tell me what I was already starting to suspect? More rest, ice, compression, and elevation – no intervention? Some might suggest that a no-show might be a better use of scarce healthcare resources, but my provider referred me to the MRI for a reason. He must have been concerned that there was something more at stake that needed to be confirmed or ruled out.  What if skipping the MRI led to a visit to the emergency room down the road, or, in a worst-case scenario, something seriously impacting my health being undiagnosed? 

4. Poor Patient Experience – Future-Leakage 

Each person I spoke with, including at my provider’s office, the imaging center, my insurance company, and their 3^rd party prior authorization support organization, was professional and well-meaning. They were engaged, caring, polite, and clearly wanted to enable my care. The problem wasn’t a people problem; it was a technology problem.  My case was simple, and the delay had a limited effect on my livelihood.  I am a highly educated, English-as-a-first-language person accustomed to navigating the healthcare industry.  I was motivated by severe pain.  Yet my experience was less than ideal. Imagine the challenge facing a factory worker injured on the job needing care just to get back to work. Imagine a mother of three working two jobs speaking little to no English and unaccustomed to the American healthcare system. Imagine an elderly person who can no longer effectively advocate for themselves without a family member to do so on their behalf. I may need imaging again in the future. So might my wife, my friend, my parent. Am I going to choose the imaging center relying on paper and fax that delayed my appointment this time around, or will “future me” choose one that employs an interoperability solution that enhances efficiency and puts patients first?  

The answer is obvious, and the solutions are simple. When a referral is sent via fax or paper, it is only 54% likely to be scheduled as opposed to 83% if sent electronically. The company I founded, Shadowbox, is designed to solve the very problems I experienced as a patient. Shadowbox’s patented technology automates the ordering and resulting process, creating efficiencies that benefit the imaging center, provider, and the patient. I imagine a future where I need a scan and am referred to an imaging center with Shadowbox in place. Rather than waiting 16 days for an imaging appointment only to be cancelled last minute.  Rather than going back and forth with my doctor’s office, the imaging center, my payor, and third-party vendors.  Workflows automated by Shadowbox would schedule my appointment within a few days with a PA in hand and without the risk of last-minute cancellation. Do you imagine that future too? With Shadowbox, the future is now.