Category: Imaging IT

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.

Google Launches Cloud Medical Imaging Suite

Posted on by Jake Fishman

Google announced what might be its biggest, or at least most public, push into medical imaging AI with the launch of its new Google Cloud Medical Imaging Suite.

The Suite directly targets organizations who are developing imaging AI models and performing advanced image-based analytics, while also looking to improve Google’s positioning in the healthcare cloud race.

The Medical Imaging Suite is (logically) centered around Google Cloud’s image storage and Healthcare API, which combine with its DICOMweb-based data exchange and automated DICOM de-identification tech to create a cloud-based AI development environment. Meanwhile, its “Suite” title is earned through integrations with an array of Google and partner solutions:

  • NVIDIA’s annotation tools (including its MONAI toolkit) to help automate image labeling
  • Google’s BigQuery and Looker solutions to search and analyze imaging data, and create training datasets
  • Google’s Vertex AI environment to accelerate AI pipeline development
  • NetApp’s hybrid cloud services to support on-premise-to-cloud data management
  • Google’s Anthos solution for centralized policy management and enforcement
  • Change Healthcare’s cloud-native enterprise imaging PACS for clinical use

It’s possible that many of these solutions were already available to Google Cloud users, and it appears that AWS and Azure have a similar list of imaging capabilities/partners, so this announcement might prove to be more technologically significant if it leads to Google Cloud creating a differentiated and/or seamlessly-integrated suite going forward.

However, the announcement’s marketing impact was immediate, as press articles and social media conversations largely celebrated Google Cloud’s new role in solving imaging’s interoperability and AI development problems. It’s been a while since we’ve seen AWS or Azure gain imaging headlines or public praise like that, and they’re the healthcare cloud market share leaders.

The Takeaway

Although some might debate whether the Medical Imaging Suite’s features are all that new, last week’s launch certainly reaffirms Google Cloud’s commitment to medical imaging (with an AI development angle), and suggests that we might see more imaging-targeted efforts from them going forward.

HIMSS 2022 Reflections

Posted on by Jake Fishman

Two years after HIMSS became COVID’s first trade show casualty, healthcare’s leading IT conference returned to Orlando with a very post-COVID vibe and a surge in imaging activity. 

Hope you had a blast if you made it to HIMSS, and here’s some highlights in case you didn’t:

The HIMSS Crowd – Unlike the Delta-impacted HIMSS 2021 conference, this year’s event boasted a full exhibitor list and reportedly solid health IT leadership attendance. However, exhibitor staff often appeared to outnumber potential customers on the show floor, prompting conversations about whether HIMSS is evolving into a B2B event and causing some vendors to question where imaging sits on IT executives’ list of priorities. 

The Mixed Cloud – PACS and enterprise imaging vendors continued to ramp up their cloud capabilities and cloud leadership messaging, with nearly everyone agreeing that the future will bring far more cloud adoption. It was also clear that many radiology practices and hospital systems (and even some PACS vendors) are still taking it slow on their path towards the cloud. 

AI in the Aisles – Only a handful of imaging AI companies had booths this year, but it wasn’t hard to find folks from AI startups walking the show floor or in meeting rooms. That’s actually consistent with previous HIMSS conferences, and it makes a lot of sense given AI startups’ limited budgets and the low count of radiology leaders at the show.

AI in the Enterprise – Although we didn’t hear much about all those PACS-based AI platforms / marketplaces that were announced several years ago, AI was positioned at the center of quite a few PACS vendors’ future diagnostic workflow strategies. These strategies still largely focused on integrating third-party AI tools, but several major enterprise imaging players (e.g. Canon, Fujifilm, Siemens) also forecasted a greater future role for their own homegrown AI tools.

The Productivity Press – With imaging growing in volume / complexity at a much faster rate than imaging teams’ own headcounts / capabilities, just about every product message focused on improving productivity and efficiency. HIMSS 2022 saw imaging vendors address this in a wide variety of ways, including remote modality operation, ultrasound AI automation, automated scanner setup, and hanging protocol standardizing (to name a few).

Expanding Ologies – HIMSS also revealed more multi-ology progress as enterprise imaging players better connected their solutions, added new ology-expanding partnerships, and integrated their acquired companies. That said, it seems like the majority of “enterprise” imaging engagements are still limited to radiology, or at least starting there.

Looking Beyond Imaging – A walk around the show floor suggests that healthcare tech is evolving at a much faster pace outside of imaging, with major adoption and technology advances in telemedicine, patient monitoring, at-home and hybrid care, and patient engagement. Although most of these solutions have little to do with radiology right now, these efforts could change how and where many patients get their care, which would have an impact on nearly all specialties. By the way, we have an excellent newsletter about this space for those looking to keep up with these trends. 

The Takeaway

After one year of digital conferences and another year of minimally-attended hybrid events, the bar has been set pretty low for 2022 trade shows. That said, HIMSS had everything that you would expect from a successful post-COVID trade show (plenty of vendors, exciting tech, strong attendance, good vibes), which is a good sign for future events as long as the pandemic cooperates.

Although HIMSS 2022 didn’t necessarily reveal any major focus changes for imaging IT, it did showcase some solid progress advancing the major imaging trends that we’ve seen over the last few years (cloud, AI, productivity, enterprise-expansion), and we’re excited to see what else this year has in store.

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-- The Imaging Wire team

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