Category: Imaging IT

Optimizing Front Office Operations through Integrated Apps and Cloud-Based RIS/PACS

Posted on by Partner Content

Paradox of High Patient Volumes

At first glance, it may appear having more patients should naturally lead to higher revenue. When you consider extra labor costs and the fact that reimbursements are decreasing, increased volume can turn into diminishing returns.

  • Basically, the cost of adding more staff can end up being higher than the value of additional patient volumes.

Optimal management of growing patient volumes requires a new way of working with automation and cloud-based apps that replace the heavy burden of manual processes.

  • By using technology to eliminate processes, medical facilities manage patient loads better without the need for more labor costs. 

This proactive approach not only improves efficiencies but also lets front office staff focus on patient needs instead of getting bogged down with administrative tasks. 

  • Ultimately, shifting towards automation and consolidation of tasks is key to maintaining clinic profitability and keeping high standards of care, especially with increasing medical demands.

How RamSoft Can Help Simplify Front Office Operations 

Achieving workflow excellence starts with a single sign-on into a unified RIS/PACS and providing access to complementary medical imaging apps via a single worklist in the cloud. 

  • By leveraging cloud applications with scalability across facilities, organizations can “build as they grow,” while maintaining control and flexibility.

RamSoft PowerServer and OmegaAI RIS/PACS platforms reduce administrative burdens and costs associated with manual processes. Here’s how…

  • Blume – Patient Portal: Patient access to diagnostic images and reports, imaging sharing with referring clinicians and family, self-scheduling, intake forms, and appointment notifications. These self-service features decrease the number of phone calls, the time needed for patient registration, and the manual process of intake form completion and filing. 
  • pVerify: Batch verification and real-time eligibility (authorization available soon) eliminates the need to call multiple insurance providers, freeing up staff time while reducing denials. 
  • PracticeSuite: An embedded solution including workflow options to accommodate entries from the RIS/PACS worklist or within the billing module. Quickly accesses top billing functions, Payment Ledger for balances and eligibility, and Payment Entry to add payment and print a receipt. 
  • openDoctor: Automated appointment notifications through SMS and email which replaces lists of confirmation calls and reduces missed appointment rates. 
  • InterFAX by Upland: Integrated digital workflow for inbound (available soon) and outbound faxes, reducing the need for manual acceptance and processing of referral or report faxes. 

Mobile Applications Are Building a Patient-Centric Experience

Protecting patient data is business-critical for all medical practices, as it is for RamSoft. We’re using Microsoft Azure Cloud to ensure all data and applications are secure.

  • Workflow optimization in medical imaging can significantly impact the patient experience, leading to increased loyalty and satisfaction. 

Is Your Practice Operating Optimally?

Explore how new automation applications, including patient engagement tools, integrated with cloud-based RIS/PACS can improve operations and profitability of your practice with RamSoft. 

Learn more on the company’s website or book a demo at RSNA 2024 for booth #6513 in the North Hall.  

U.K.’s Massive Diagnostic IT Project

Posted on by Brian Casey

The U.K. is planning a massive project – worth close to $1B – to procure new IT tools for medical diagnostic use. While details of the plan are still sketchy, it involves the acquisition of both radiology and cardiology PACS, as well as AI.

The U.K.’s NHS has become one of the world’s hottest test beds for medical IT adoption as the service struggles to reconcile a static workforce with rising demand for healthcare services.

  • For example, the NHS last year issued the AI Diagnostic Fund, which provided £21 million ($28M) for a variety of AI implementation projects across 64 NHS trusts.

But the new tender offer dwarfs that investment. NHS has proposed a Digital Diagnostic Solutions project to serve as “a route to market for departmental wide diagnostic IT solutions.”

  • The value of the project is pegged at £700M ($923M), a massive investment in medical IT by any metric. 

The offer is being led by NHS Supply Chain, the governmental agency responsible for procuring medical equipment within the NHS. 

  • The program’s tender offer states that the Digital Diagnostic Solutions project “is to be the new Framework for the Medical IT Departmental Software and Hardware Solutions framework within NHS Supply Chain.”

It includes the following provisions: 

  • Acquisition of radiology PACS, cardiology PACS, RIS, cardiovascular information systems (CVIS), laboratory information management systems (LIMS), and vendor-neutral archives (VNAs).
  • Software acquired through the program “will sit alongside” other capital equipment like X-ray, MRI, and CT systems.
  • It will also include 3D software, diagnostic AI software, and endoscopy image management applications.

Publication of an invitation to tender will happen in December 2024, and the contract award will be in July 2025, with the framework itself starting in August 2025. 

The tender offer was published just a few days before a government-commissioned report that said the NHS was in “serious trouble” and that was harshly critical of the system’s transformation to digital operation.

  • And that report came after a July election that saw the Labour party win power for the first time in 14 years – raising hopes that it would approach NHS funding differently than the previous Conservative governments. 

The Takeaway

Does the Digital Diagnostic Solutions project represent a new commitment to funding IT innovation from the Labour government? Or is it simply a rebranding of the NHS’ existing procurement activities? Stay tuned. 

Top 6 Radiology Trends of 2024’s First Half

Posted on by Brian Casey

You can put the first half of 2024 in the books … and it was full of major developments for radiology. What follows are the top six trends in medical imaging – one for each month of the first half.

  • The Rise of AI for Breast Screening – The first half of 2024 saw the publication of studies conducted in Norway and Denmark that underlined the potential role of AI for breast screening, particularly for ruling out exams most likely to be normal. But research conducted within Europe’s paradigm of double-reading workflow for 2D mammograms may not be so relevant in the US, and more studies are needed.
  • Mammography Guideline Controversy – Changes to breast screening guidelines in both the US and Canada were first-half headlines. In the US, the USPSTF made official its proposal to lower to 40 the recommended age to start screening, but many were disappointed it failed to provide stronger guidance on dense breast screening. Things were even worse in Canada, where a federal task force declined to lower the screening age from 50 to 40. Canadian advocates have vowed to fight on at the provincial level. 
  • AI Funding Pullback Continues – The ongoing pullback in venture capital funding for AI developers continues. A study by Signify Research found that not only did VC funding fall 19% in 2023, but it got off to a slow start in 2024 as well. The new environment could be putting more pressure on AI firms to demonstrate ROI to both healthcare providers and investors, while also having broader implications – a major AI conference rescheduled a show that had been on the calendar for May, citing “market conditions.” On the positive side, Tempus AI’s IPO boomed, raising $412M. 
  • Opportunistic Screening Gains Steam – The concept of opportunistic screening – detecting pathology on medical images acquired for other indications – has been around for a while. But it’s only really started to catch on with the development of AI algorithms that can process thousands of images without a radiologist’s involvement. The first half of 2024 saw publication of several exciting studies for indications including detecting osteoporosis, scoring coronary artery calcifications, and predicting major adverse cardiac events. 
  • ChatGPT Frenzy Subsides – The frenzied interest in ChatGPT and other generative AI large language models seen throughout 2023 seemed to subside in the first half of 2024. A quick search of The Imaging Wire archives, for example, finds just four references to ChatGPT in the first six months of 2024 compared to 21 citations at the same point in 2023. LLM developers need to address major issues – from GenAI’s “hallucination effect” to potential misuse of the technology – before LLMs can be used in clinical settings.

The Takeaway

The midpoint of the year is a great time to take stock of radiology’s progress and the issues that have bubbled to the surface over the past six months. In 2024’s back half, look for renewed attention on breast screening as the FDA’s density reporting rules go into effect in September, and keep on the lookout for signs that real-world AI adoption is growing, even as AI developers look for consolidation opportunities.

Top 4 Trends from SIIM 2024

Posted on by Brian Casey

SIIM 2024 concluded this weekend, and what a meeting it was. The radiology industry’s premier imaging IT show returned to National Harbor, MD, for the first time since 2018, where the Biosphere-like environment of the Gaylord National Resort and Convention Center offered a respite from the muggy weather outside. 

SIIM is always a great place to check in on new imaging IT technologies like PACS, AI, and enterprise imaging, and hot topics at SIIM 2024 included…  

  • AI Needs to Get Real (World): Research studies showing AI’s value are fine, but developers need to show that AI works in real-world settings before wider adoption will occur. Fortunately that’s started with landmark studies published recently for use cases like breast and osteoporosis screening. Meanwhile, scuttlebutt on the SIIM 2024 exhibit floor reinforced that start-ups are navigating an ugly funding environment, and many industry observers are predicting a wave of AI consolidation. 
  • Outlook Clears for the Cloud: Cloud-based imaging has struggled to catch on for years, but that’s starting to change as healthcare providers warm to the concept of letting third parties oversee their patient data. And there are signs that imaging IT vendors that were quick to develop cloud-based versions of their PACS software are reaping the rewards.
  • Enterprise Imaging Grows Up: This year’s meeting marked the 10-year anniversary of enterprise imaging, as dated from the start of the SIIM-HIMSS collaboration in 2014. The anniversary is a milestone worth observing, but it also raises questions about what the next 10 years will look like, and how AI and data from other -ologies will be integrated into enterprise networks. 
  • Cybersecurity Takes Priority: Several high-profile cybersecurity breaches at healthcare vendors and providers in the last year highlight that not enough is being done to keep patient data secure. Will migrating to the cloud help? Only time will tell.

The Takeaway

SIIM’s collegiality and coziness has always been a selling point for the meeting, even back in the days when it was known as SCAR. This year didn’t disappoint, as deals got done and relationships were built at the Gaylord National.  

Be sure to visit our YouTube channel and LinkedIn page to view our video interviews from the floor of the meeting – it was great seeing you all at the show!

Indies Surge in Imaging IT

Posted on by Brian Casey

The market for medical imaging IT technology continues to shift, with a pair of surging independent players growing rapidly in a sector that’s long been dominated by multinational OEMs. That’s according to the latest report on the imaging IT market by UK market intelligence firm Signify Research. 

The new report is projecting that the global market for imaging information technology will grow 18% over the next few years, from $5.6B in 2023 to $6.6B in 2028. 

  • Radiology will continue to dominate with a majority of sales, with cardiology IT a distant – but growing – second. Advanced visualization and operational workflow tools will make up the rest.

In terms of vendors, the top three market leaders of 2023 were GE HealthCare, Philips, and Fujifilm, but more recently, Visage Imaging and Sectra have been gaining market share. 

  • The report echoes recent news that has seen some of the largest multi-site enterprise imaging installations going to Visage and Sectra; a recent KLAS Research report also showed both companies’ growing momentum. 

Some of the other major points from the report include … 

  • Major growth in cloud deployment will occur – by 2028, 37% of the global imaging IT market will be in either hybrid or fully hosted environments
  • Cloud will represent 44% of the total radiology IT market by 2028
  • On a regional basis, the Middle East will see “significant growth” in imaging IT from 2024 to 2026, particularly in the Gulf States
  • Recovery is expected in China and the ASEAN nations, while India’s growing economy is driving healthcare digitization
  • Latin America is showing rising interest in AI and cloud technologies, but national elections could complicate matters

The Takeaway
The new Signify Research report underscores the evolving nature of the imaging IT market, as independent vendors rise to challenge multinational OEMs that dominated the sector for years. Be sure to check out Signify’s helpful infographic on LinkedIn that succinctly wraps up the changes.

Predicting Patient Follow-Up for Imaging Exams

Posted on by Brian Casey

There’s nothing more frustrating than patients who don’t comply with follow-up imaging recommendations. But a new study in JACR not only identifies the factors that can lead to patient non-compliance, it also points the way toward IT tools that could predict who will fall short – and help direct targeted outreach efforts.

The new study focuses specifically on incidental pulmonary nodules, a particularly thorny problem in radiology, especially as CT lung cancer screening ramps up around the world.

  • Prevalence of these nodules can range from 24-51% based on different populations, and while most are benign, a missed nodule could develop into a late-stage lung cancer with poor patient survival. 

Researchers from the University of Pennsylvania wanted to test a set of 13 clinical and socioeconomic factors that could predict lack of follow-up in a group of 1.6k patients who got CT scans from 2016 to 2019. 

  • Next, they evaluated how well these factors worked when fed into several different types of homegrown machine learning models – precursors of a tool that could be implemented clinically – finding …
  • Clinical setting had the strongest association in predicting non-adherence, with patients seen in the inpatient or emergency setting far more likely skip follow-up compared to outpatients (OR=7.3 and 8.6)
  • Patients on Medicaid were more likely to skip follow-up compared to those on Medicare (OR=2)
  • On the other hand, patients with high-risk nodules were less likely to skip follow-up compared to those at low risk (OR=0.25) 
  • Comorbidity was the only one of the 13 factors that was not predictive of follow-up 

The authors hypothesized that the strong association between clinical setting and follow-up was due to the different socio-demographic characteristics of patients typically seen in each environment. 

  • Patients in the outpatient setting often have access to more resources like health insurance, transportation, and health literacy, while those without such resources often have to resort to the emergency department or hospital wards when they become sick enough to require care.

In the next step of the study, the data were fed into four types of machine learning algorithms; all turned in good performance for predicting follow-up adherence, with AUCs ranging from 0.76-0.80. 

The Takeaway

It’s not hard to see the findings from this study ultimately making their way into clinical use as part of some sort of commercial machine-learning algorithm that helps clinicians manage incidental findings. Stay tuned.

Making Screening Better

Posted on by Brian Casey

While population-based cancer screening has demonstrated its value, there’s no question that screening could use improvement. Two new studies this week show how to improve on one of screening’s biggest challenges: getting patients to attend their follow-up exams.

In the first study in JACR, researchers from the University of Rochester wanted to see if notifying people about actionable findings shortly after screening exams had an impact on follow-up rates. Patients were notified within one to three weeks after the radiology report was completed. 

They also examined different methods for patient communication, including snail-mail letters, notifications from Epic’s MyChart electronic patient portal, and phone calls. In approximately 2.5k patients within one month of due date, they found that follow-up adherence rates varied for each outreach method as follows:

  • Phone calls – 60%
  • Letters – 57%
  • Controls – 53%
  • MyChart notifications – 36%

(The researchers noted that the COVID-19 pandemic may have disproportionately affected those in the MyChart group.) 

Fortunately, the university uses natural language processing-based software called Backstop to make sure no follow-up recommendations fall through the cracks. 

  • Backstop includes Nuance’s mPower technology to identify actionable findings from unstructured radiology reports; it triggers notifications to both primary care providers and patients about the need to complete follow-up.

Once the full round of Backstop notifications had taken place, compliance rates rose and there was no statistically significant difference between how patients got the early notification: letter (89%), phone (91%), MyChart (90%), and control (88%). 

In the second study, researchers in JAMA described how they used automated algorithms to analyze EHR data from 12k patients to identify those eligible for follow-up for cancer screening exams.

  • They then tested three levels of intervention to get people to their exams, ranging from EHR reminders to outreach to patient navigation to all three. 

Patients who got EHR reminders, outreach, and navigation or EHR reminders and outreach had the highest follow-up completion rates at 120 days compared to usual care (31% for both vs. 23%). Rates were similar to usual care for those who only got EHR reminders (23%).

The Takeaway

This week’s studies indicate that while health technology is great, it’s how you use it that matters. While IT tools can identify the people who need follow-up, it’s up to healthcare personnel to make sure patients get the care they need.

Better Together at SIIM

Posted on by Brian Casey

Humans have a deep-seated need for interpersonal contact, and understanding that need should guide not only how we structure our work relationships in the post-COVID era, but also our development and deployment of new technologies like AI in radiology. 

That’s according to James Whitfill, MD, who gave Thursday’s opening address at SIIM 2023. Whitfill’s talk – which was followed by a raucous audience participation exercise – was a ringing demonstration that in-person meetings like SIIM still have relevance despite the proliferation of Zoom calls and remote work. 

Whitfill, chief transformation officer at HonorHealth in Arizona and an internist at the University of Arizona, was chair of the SIIM board in 2020 when the society made the difficult decision to move its annual meeting to be fully online during the pandemic.

The experience led Whitfill to ponder whether technology designed to help us work and collaborate virtually was an adequate substitute for in-person interaction. Unfortunately, the research suggests otherwise: 

  • Numerous studies have demonstrated the negative effect that the isolation of the COVID pandemic has had on adolescent mental health and academic performance 
  • Loneliness can also have a negative effect on physical well-being, with a recent U.S. Surgeon General’s report finding that prolonged isolation is the health equivalent of smoking 15 cigarettes a day
  • Peer-reviewed studies have shown that people working in in-person collaborative environments are about 10% more productive and creative than those working virtually. 

Whitfill’s talk was especially on-point given recent research indicating that workers across different industries who used AI were more lonely than those who didn’t, a phenomenon that shouldn’t be ignored by those planning radiology’s AI-based future. 

That said, virtual technologies can still play a role in making access to information more equitable. Whitfill noted that some 160 people were following the SIIM proceedings entirely online, and they otherwise would not have been able to benefit from the meeting’s content.

To drive the point home, Whitfill then had audience members participate in a team-based Rochambeau competition that sent peals of laughter ringing through Austin Convention Center.  

The Takeaway
Whitfill’s point was underscored repeatedly by SIIM 2023 attendees, who reiterated the value of interpersonal connections and networking at the conference. It’s ironic that a meeting devoted at least in part to intelligence that’s artificial has made us better appreciate relationships that are real.

Headlines from HIMSS 2023

Posted on by Brian Casey

CHICAGO – It does indeed feel like 2019 again at HIMSS 2023, which opened this week in the Windy City. Major stories at the show include generative AI for medical use, consumer cloud players planting their flags in healthcare, and the ongoing need for healthcare IT to help with rising medical procedure volume and growing burnout among healthcare professionals.

But an underlying subtext of this week’s show is that the disruptions and travel restrictions of the COVID-19 pandemic are behind us. At long last the HIMSS show has returned to a sense of normalcy. 

On-site attendance at HIMSS 2022 in Orlando was around 29k, down sharply from the 43k at HIMSS 2019. Early midweek figures from HIMSS 2023 place attendance at 35k; this sounds about right based on the crowded hallways, presentation rooms, and technical exhibits at McCormick Place (and especially the line at Starbucks in the Grand Concourse). 

What are other trends at HIMSS 2023? They include: 

  • Generative AI spreading throughout healthcare. Radiology was one of the first medical specialties to explore the potential of large language models like ChatGPT, but healthcare IT is getting into the act as well. At HIMSS, vendors are inking partnerships to put ChatGPT to work for functions like clinical decision support.
  • Cloud storage providers are in healthcare to stay. After years of dabbling, the large cloud players – Amazon, Google, and Microsoft – appear to be making a major play in cloud-based healthcare, signing partnerships with IT and radiology OEMs.
  • Healthcare IT helping providers. The conversations at HIMSS 2023 are focusing on leveraging technology to help providers cope with rising procedure volume and burned-out staff. 
  • Pathology is finally ready to go digital. The technological challenges to digitizing, managing, and archiving massive whole slide images appear to be solved. Now all that’s left is to convince pathologists to take the digital plunge.

The Takeaway

Prior to the pandemic, HIMSS was perhaps the fastest-growing healthcare conference, and this week in Chicago shows it’s back. The crowded halls are a welcome sign not only for healthcare IT, but also for other medical meetings on the calendar.  

Check out videos from HIMSS 2023 on our LinkedIn page and YouTube channel. And keep an eye out for the editorial teams for Imaging Wire and our sister publications Cardiac Wire and Digital Health Wire in McCormick Place – we’d love to say hello!

Software Closes Radiology Reporting Loop

Posted on by Brian Casey

In the never-ending quest to get referring physicians to follow radiologist recommendations for follow-up imaging, Massachusetts researchers in JAMA Network Open offer an IT-based solution: Structured reporting software that was found to triple the number of radiology reports judged to be complete. 

A recent study found that 65% of radiologist recommendations for follow-up imaging aren’t followed by referring physicians. Authors of that study found that recommendations that were strongly worded and communicated directly to referring doctors had higher uptake. 

But what if radiologists don’t follow this advice? In the new paper, researchers from Brigham and Women’s Hospital and Harvard Medical School offer a more structured solution thanks to software developed as part of their Addressing Radiologist Recommendations Collaboratively project. 

The ARCC software is a closed-loop communication system that’s designed to channel radiologist recommendations into a structured format that’s clearly understood, while also tracking whether they were accepted and fulfilled. The ARCC tool runs separately from the radiologist’s dictation software, so while it asks them to include a standardized recommendation sequence in their report, it leaves the specific free-text language up to them. 

Under the ARCC criteria, the main factors that make up a complete follow-up recommendation are:

  • Reason for imaging study
  • Timeframe when study should be completed
  • Imaging modality to be used

The researchers implemented the ARCC software in October 2019 in thoracic imaging, and rolled it out to other departments through December 2020. Use of the software was “strongly encouraged but voluntary.” 

In testing the ARCC software’s effectiveness, the researchers found that the number of follow-up recommendations considered to be complete – with all three key elements – rose from 14% to 46%. Even so, one-third of reports filed with ARCC “still contained ambiguous language” in the free-text section – indicating that old habits are hard to break.

The Takeaway

Radiologists may hate it when their recommendations for follow-up imaging are ignored, but referring physicians are also frustrated with free-text radiology reports that are wishy-washy and contain vague impressions. The ARCC software could bridge the gap by steering radiologists toward recommendations that are more concrete and specific – and more likely to be followed.

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