Outside Rebound | Hold the TKA X-Ray

“None of us know what’s going on with our bones until they start to break.”

A British osteoporosis sufferer on the UK’s lacking incidental OP follow-up standards.

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The Imaging Wire

Hospitals’ Outside Rebound

A new McKinsey survey found that healthcare system leaders expect patient volumes to surpass 2019’s levels by next year, while revealing an interesting shift in how/where many of these patients will be getting their care.

The Rebound – The leaders from 100 large private US hospitals reported that their ED and inpatient/outpatient volumes returned to 2019 levels in July 2021 (so, somewhat pre-Delta) and forecast that 2022 volumes will be 5%-8% above 2019.

The Outpatient Shift – Outpatient procedures are expected to drive much of this future patient growth (+8% in 2022, +9% in 2023), with the biggest outpatient increases in orthopedics, psychiatry, and cardiology.

The Virtual Shift – Although it would take another lockdown to return to 2020’s virtual care numbers, the leaders expect virtual visits to represent around 15% of their outpatient volume in 2022/2023, 300% higher than in 2019.

It’s Not Just McKinsey – You probably don’t need a prestigious consulting firm to tell you that more procedures are moving to outpatient settings and more patient visits are being held virtually. The outpatient shift has been going on for some time, and the recent evolution of telehealth tech and home care delivery has brought some major home care commitments from the biggest systems in the country. We even launched an excellent new newsletter to help providers keep up with healthcare’s virtual shift.

The Radiology Impact – Technically the McKinsey forecast didn’t mention imaging once, but patients’ continued shift to beyond hospital walls will definitely have an imaging impact, including more virtual radiologist consultations, more outpatient image-guided procedures, and more at-home and near-home imaging. It could also mean less in-hospital imaging.

OLGH’s PowerScribe One Improvements

See how the Ochsner Lafayette General health system improved its radiology report quality and efficiency when it migrated to PowerScribe One.

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How AI is Changing Population Health

This Zebra-Med post details how AI is revolutionizing population health programs through automation, workflow integration, and significantly expanding early disease detection.

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The Wire

  • Hold the Post-TKA X-Ray: A new study in “The Knee” stated a solid case against performing X-rays after total knee arthroplasty procedures (TKA), finding that post-TKA X-rays’ “low clinical utility” doesn’t justify their costs and/or radiation. Analysis of 3,831 post-TKA X-rays (1,258 patients) found that only 13 X-rays had orthopaedic findings and just 11 led to management changes, resulting in over $1m in unnecessary X-rays.
  • RICOH 3D for Healthcare: Ricoh USA launched its RICOH 3D for Healthcare solution, which healthcare providers can use to design and produce patient-specific 3D-printed anatomic models. Providers would use IBM Watson Health’s iConnect Access platform to create 3D anatomic designs and Ricoh would then produce and deliver the finished 3D models.
  • AI Bridges DM-DBT Gap: AI can bring digital mammography’s cancer detection rates closer to DBT. That’s from a new Swedish study that analyzed 14,768 women’s DM and DBT screening exams (136 screening detected cancers, 41 only detected w/ DBT), and then applied ScreenPoint Transpara to the DM exams. Transpara flagged 75% of the DM detected cancers (71 of 95) and 44% of the DBT-only detected cancers (18 of 41), suggesting that AI could significantly improve DM’s cancer detection rates (from 6.4 to 7.7 per 1k women) and bring it closer to DBT’s rates (8.7/1k).
  • Eon EPM Liver: Eon Healthcare unveiled its new Eon EPM Liver patient management software, which allows providers to longitudinally manage patients who are at risk of liver cancer and/or patients who had incidental liver lesions documented in their radiology reports. Eon EPM Liver uses Computational Linguistics to flag incidental findings in radiology report text (94% accuracy) and gives providers a dashboard to track both at-risk and incidentally-flagged patients.
  • Virtual Enhanced CMRI: A team of Oxford MRI scientists developed an AI-based cardiac MRI enhancement technique that reportedly enhances CMRI images well enough to rival late gadolinium enhancement CMRI scans (LGE CMRI), without requiring contrast administration. The researchers had four blinded radiologists review CMRIs enhanced with the new Virtual Native Enhancement (VNE) tech and traditional LGE-based CMRIs. VNE had significantly better image quality than LGE, while achieving high agreement with LGE for detecting and quantifying myocardial lesions.
  • Failed Osteoporosis Follow-Ups: A recent BBC article highlighted what the Royal Osteoporosis Society (ROS) describes as the UK’s “urgent” need to improve how the country’s radiologists flag and refer patients with suspected osteoporosis. The article told the story of a 61-year-old British woman who realized she had severe osteoporosis after she “could have done something about it,” and then detailed the UK’s lack of incidental imaging follow-up standards for osteoporosis.
  • Effective CESM: USC researchers found that contrast-enhanced spectral mammography (CESM) can be an effective alternative to contrast-enhanced breast MRI (CEMRI) for assessing newly diagnosed breast cancer. Among 41 multiethnic women with invasive breast cancer, CESM fell just short of CEMRI for detecting malignant lesions (sensitivity 93.1% vs. 96.55%) but achieved a higher PPV (96.43% vs. 82.35%) and specificity. CESM also matched CEMRI for estimating tumor size (ICCs: 0.85 vs. 0.87 compared to surgery).
  • Info Blocking Compliance: Healthcare Administrative Partners recently shared some helpful guidelines that radiology practices can follow to stay compliant with the US’s new information blocking laws. Practices are in violation of the info blocking rules any time they knowingly interfere with a patient’s access to their electronic health information (EHI), including things like delayed responses to info requests. HAP recommends that practices: 1) confirm technical compliance with their EHI system vendor and 2) review their internal policies/procedures and make sure employees understand how to respond to info requests.
  • COVID’s Hospital Impact: A new report from Alvarez & Marsal revealed that the 25 largest nonprofit US health systems saw net patient revenue drop 21% from Q4 2019 to Q2 2021. During that period, discharges decreased 18%, surgeries fell 36%, and emergency room visits declined 31%.
  • Everlight’s New PE Parent: Major Australia and UK teleradiology firm Everlight Radiology has a new private equity parent after Lifebridge acquired a majority stake in the company for over $500m. Everlight Radiology already has a solid teleradiology presence (15 hubs, 500 rads, 250 client sites in AUS/NZ, UK, Ireland) and will reportedly use its refreshed PE backing to ramp up its acquisition activity.
  • Delayed MRI Lawsuit: The parents of a deceased 14-year-old boy are suing Arkansas Children’s Hospital for negligence, alleging that an earlier MRI could have saved his life. The boy was admitted with a skull fracture and brain bleed after an ATV crash, but was moved from the ICU and then sent to a rehab without receiving a head MRI because the boy’s orthodontic braces might have interfered with the scan. He later received an MRI after continued deterioration, but he unfortunately died a week after he was admitted.
  • Breast RadRes Variations: A new Huntsman Cancer Institute survey revealed surprising variations in how breast radiologists believe breast imaging resident programs should be structured. The survey of 109 breast radiologists (2,188 were asked to participate), revealed wide differences regarding what residents should focus on during their first rotation (e.g. 37% mainly screening, 21% mainly diagnostics) and when breast MRI should be introduced (30% first rotation, 50% second).

GE & AI-Enabled Imaging Centers

Some small imaging centers haven’t been getting a fair chance with AI – here’s how GE Healthcare plans to change that.

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The Resource Wire

  • New ergonomics and enhanced auto-positioning are just a few of the ways that Canon Medical System’s new OMNERA 500A DR system improves technologist workflow and patient care. Check out the rest here.
  • Check out this Blackford Analysis video detailing how its AI platform streamlines AI adoption and workflows, allowing radiology teams to achieve AI’s clinical benefits without operational sacrifices.
  • Why United Imaging’s CT (uCT)? United Imaging’s Z-Detector architecture enables high resolution and low noise imaging across the entire uCT portfolio. United Imaging also offers the same CT quality and software platform across all systems (you choose your slices and speed), and all uCTs can image a wide variety of patient and exam types, including large patients, patients with metal implants, angiography, and cardiology exams.

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