An RVU for You: Creating and Implementing a Time-based Productivity Metric

Purpose: In healthcare, productivity is of paramount importance. While provider services are incredibly diverse, a single metric has emerged for quantifying output: the Relative Value Unit (RVU). For years, our practice has acknowledged that the RVU system does not fully recognize every individual’s contribution to our success. We present a novel approach to assigning value to the services performed by radiologists and the impact that this model has had on individual productivity, practice productivity, and individual job satisfaction.

Methods/Materials: This presentation describes our group’s new system for tracking productivity as an alternative to the RVU system, named the Internal Value Unit (IVU) system. The traditional RVU system does not accurately assess the work required for many exam types. It also disregards vital non-RVU contributions (NRCs), such as tumor boards, exam protocoling, teaching, and administrative work. We describe the development of the IVU system utilizing time spent as the universal currency. Whether preparing for a tumor board or reading a diagnostic study, there is an average amount of time we could assign to that activity to create fair value.

Results: After implementation, we surveyed our group’s radiologists to gather feedback on the IVU system. The survey responses indicated that most of the group’s radiologists were more satisfied with the IVU system than the RVU system. For example, 90% of the radiologists felt that the IVU system was a better way to measure productivity than the RVU system. 81% of radiologists felt that the IVU system better accounts for clinical activities outside of reading cases such as tumor boards and teaching. 93% of radiologists would opt against returning to the previous RVU system.

In addition to gains in radiologist satisfaction, our data analysis demonstrated significant productivity increases. For example, the year over year provider average shift productivity showed improvements in multiple metrics, including IVU without NRCs (+7.6%), IVU with NRCs (+9.2%), and RVU (+3.8%).

Conclusions: By presenting our methodology and experience, we hope that this novel approach can be reproduced by other groups resulting in similar benefits.