Big AI Investments | Specialist Faceoff | AI’s Med Student Impact

“This is not peanuts.”

Philips CEO, Frans van Houten, on the $69 million profit hit the company is expecting in 2019 as a result of the US-China trade war and the “hundreds of millions” of euros worth of production the company is shifting to-and-from the US and China to minimize the impact of the tariffs.

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The Imaging Wire

AI Investments Still Surging
A new report from Signify Research confirms that the growing buzz around medical imaging AI has coincided with significantly increased investments. Signify Research reported that investments in AI-enabled medical image analysis companies between 2014 and 2018 surpassed $1.2 billion, including $580 million in 2018 alone. HeartFlow continues to dominate fundraising, generating $476.6 million over the four years and $240 million in 2018, followed by VoxelCloud (~$80m 4yrs, $50m 2018), InferVision (~$73m, $46m), Deepwise (~$51m, $22.6), and Zebra ($50m, $30m). As expected from 2018’s hefty investment numbers, Signify found that company launches and associated early-stage investments have declined since a 2015-2017 peak (29 early-stage deals in 2017 vs. 15 in 2018), while later-stage investments doubled in 2018 and are expected to continue to lead 2019’s funding activity. The most investor dollars are flowing to US and Asia-based companies and to companies focused on general imaging and cardiovascular imaging applications (with the US and CV numbers helped by HeartFlow’s massive investments), while investments in EMEA AI companies appear to be lagging (especially outside of Israel). The Signify report provides some solid details and helpful visuals and is worth a look if you’re interested in AI investments.

Specialist Opinions
The Toronto Star’s Opinion section became home to a debate on whether a move to protect the income potential of Ontario’s radiologists was justified. The op-ed faceoff started with a piece by former Ontario Deputy Health Minister (and former surgeon), Dr. Bob Bell, criticizing local radiologists for trying to leave the Ontario Medical Association to protect their own financial interests even though they’ve already enjoyed extraordinary income growth (+ 163% avg.) and labor declines (- 12% days) over the last 20+ years, owing their reduced workload to taxpayer-funded technologies. Within two weeks Canadian radiologist, Dr. Andrew Chung, clapped back against what he views as the media’s frequent and unnecessary targeting of radiologists, suggesting that an overall misunderstanding of the specialty (beyond its high-income potential) has made radiologists “convenient bogeymen against whom it is easy to sway the public and even our fellow physicians against.” Dr. Chung pointed to radiologists’ growing responsibilities for diagnostic interpretations and image-guided procedures (both volume and complexity) as evidence of radiologists’ importance, which can be underestimated because of rads’ behind-the-scenes status and misunderstandings regarding how/whether new technologies are actually simplifying radiology. This type of specialist rivalry may be common in cafeterias and physician message boards, but taking it to the op-ed page is unique and its probably a path worth avoiding.

Imaging Order Errors
Imaging order errors landed in the middle of a debate over self-reporting, EHR functionality, and clinician accountability, after emergency department doctors at Rhode Island Hospital were served with subpoenas for medical misconduct and the hospital received a consent decree requiring it to report any incidents or near-misses. The Rhode Island Department of Health’s efforts to discipline the provider and the ED doctors for four imaging errors (wrong-side mammogram, wrong-patient angiogram and brain angiography, wrong-vertebra vertebroplasty… all in under a month) gained national attention. The medical community was quick to point out that the RI DOH’s penalties may dissuade clinicians from self-reporting in the future and don’t address the underlying issues that led to these errors (EHR complexity, high ED volume), while others highlighted the need to reduce the high number of EHR-related imaging order errors.

Doctor AIzimov
Russian researchers developed a new AI-based CT scan lung cancer diagnostic system that can mark images for pathology and distinguish between malignant and benign tumors in 20 seconds. The appropriately named Doctor AIzimov solution (get it, “AI”zimov) uses randomly selected segments of CT images connected by chords, then analyzes nodules “in the form of compact and simple histograms” (vs. entire complex CT images), to reduce the diagnostic heavy lifting (CTs can be 1GB). Doctor AIzimov will be tested at the St. Petersburg Clinical Research Center this year and expand to other medical institutions going forward, with plans to eventually support other organs and additional modalities (specifically ultrasound and X-ray).

Two Sides on AI’s Med Student Impact
The debate over how the threat of AI is influencing the career decisions of would-be radiologists heated up over the last few weeks. It started when Ross University medical student, Kush Purohit, published a rebuttal to a previous study from a group of University of British Columbia radiologists that revealed a high level of concern about the future of radiology among Canada’s med students. Purohit assured that although AI may cause anxiety, interest in radiology among medical students is still growing due to greater awareness, the appeal of IR, and radiology’s lifestyle benefits. Purohit backed-up this claim with the fact that 6.9% of all National Residency Match Program applicants applied to diagnostic radiology programs in 2017/2018, marking the specialty’s highest percentage since 2010 and representing a 38.8% increase since 2014/2015. The Canadian group was quick to issue a response to Purohit, noting that the 2014/2015 comparison period followed five years of application declines, and metrics such as radiology job competitiveness (71% in 2018 vs. 89% in 2009) and the radio of students placing radiology as their top specialty (1.4 in 2018 vs. 0.9 in 2001 – lower is more competitive) are far below their historical peaks.

The Wire

  • iSchemaView announced upgrades to its RAPID stroke imaging software, including an update to the RAPID APP (allows viewing of raw Non-Contrast CT images and CTA source data), new custom notification features for any RAPID module (text, email, app notifications), the added ability to customize the delivery of critical Personal Health Information (limits content based on regulations, policies, or preferences), and notification support for RAPID’s latest indication for thrombectomy.

The Resource Wire

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  • POCUS Systems is approved as a Veteran Owned Business with the US Government Office of Veterans Business Development, paving the way for partnerships with the federal healthcare delivery system.

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