Service Rights Fight | Human-AI Hybrid | AI Code

“The rule is a monumental step forward for autonomous AI . . .”

Digital Diagnostics on CMS’ decision to reimburse physicians for autonomous AI interpretations for the first time. This first one is for ophthalmology.

Imaging Wire Sponsors

  • Bayer Radiology – Providing a portfolio of radiology products, solutions, and services that enable radiologists to get the clear answers they need.
  • GE Healthcare – Providing point of care ultrasound systems, from pocket-sized to portable consoles, designed to support your clinical needs and grow along with your practice.
  • Healthcare Administrative Partners – Empowering radiology groups through expert revenue cycle management, clinical analytics, practice support, and specialized coding.
  • Hitachi Healthcare Americas – Delivering best in class medical imaging technologies and value-based reporting.
  • Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter.
  • Riverain Technologies – Offering artificial intelligence tools dedicated to the early, efficient detection of lung disease.

The Imaging Wire

The Right to Repair Act

A pair of U.S. Senators just introduced new legislation that would expand 3rd party medical device servicers’ rights during the COVID-19 crisis. This might seem straightforward to folks outside of healthcare tech, but it is definitely not.

  • The Right to Repair Act of 2020 – Senator Ron Wyden and Representative Yvette D. Clark’s new legislation gives 3rd party servicers access to service materials / tools, protects them against copyright challenges, and exempts them from safety standards, while allowing hospital employees to service their own equipment even if their OEM contracts forbid it.
  • The COVID Proxy Fight – The new act would only cover service performed during the COVID crisis, but given how long servicers and OEMs have battled over this issue, it definitely has post-COVID implications.
  • MITA’s Stand – MITA quickly took a stand against the legislation, arguing that it would give “unregulated” servicers “unfettered access” to proprietary service materials / tools and does not hold these servicers accountable to FDA regulations.

MIT’s Human-AI Hybrid

MIT scientists developed a machine learning system that can diagnose a range of issues using chest X-rays (pneumonia, lung collapse, enlarged heart) and knows when to defer interpretations to radiologists.

  • Human Deferrals – The Human-AI hybrid system uses a “classifier” that can predict a certain subset of tasks (e.g. interpret an image), and a “rejector” that decides whether a given task should be handled by a human expert. Most importantly, the system can adapt when and how often it defers to a radiologist based on factors like availability and level of experience (e.g. withholding deferrals when doctors are very busy).
  • Hybrid Advantages – The researchers found that their hybrid system achieves better accuracy than baselines, highlighted by its 8% advantage identifying enlarged hearts versus either radiologists or the AI tool on their own. The approach also has lower computational costs and can be trained with far smaller data samples than other AI tools.
  • Next Up – This system hasn’t actually been tested with real human experts, so a study with actual radiologists is next. The researchers will also explore how to develop systems that can defer to several experts at once (e.g. decided whether to defer to a subspecialist).

The Wire

  • CMS’ Autonomous AI Code: CMS revealed that it will cover autonomous AI starting in January, creating a CPT code (9225X) for an AI tool that interprets retina images without involving ophthalmologists. This isn’t ‘our’ type of imaging and the new code hasn’t received much attention in the radiology media, but it certainly sets an interesting precedent for imaging AI.
  • RadNet & Hologic’s AI Partnership: RadNet and Hologic just launched a partnership that will leverage RadNet’s mammography patient data and workflow expertise to develop and refine Hologic’s breast health AI tools. To make it even more win-win, RadNet will upgrade its fleet of Hologic mammography systems (adding Hologic’s 3DQuorum DBT reconstruction software), while Hologic will integrate RadNet’s recently acquired suite of DeepHealth-based AI tools into its AI ecosystem.
  • Overscreening the Elderly: A new study in JAMA Network Open revealed that 45% of older adults are overscreened for cancer, with particularly high overscreening rates among women in metro areas. The telephone survey (n = 176,348) revealed that older adults are screened for colorectal (56.2% of women, 59.3% of men), cervical (45.8%), and breast cancers (74.1%) despite being beyond screening age limits (75, 65, and 75-years, respectively).
  • Pink Card Screenings: A Mass General study detailed how a walk-in breast cancer screening program improved access for historically under-screened patient groups. Through MGH’s ‘Pink Card’ program, physicians provided patients who were due for screening mammograms (SMs) with Pink Cards that the patients could use for walk-in SMs (n = 733 of 3,688 SMs performed). The Pink Card users were more likely to be minority, non-native English speakers, and Medicaid-insured than women who attended pre-scheduled screening visits, while fewer Pink Card users were up to date with their biennial SMs (31.9% vs. 66.6%).
  • Signify on Siemens & Varian: Signify Research shared a positive take on Siemens Healthineers’ acquisition of Varian Medical. The firm praised the combination of Varian’s radiation therapy tech with Siemens’ imaging portfolio (potentially making Siemens an end-to-end oncology provider), their growth opportunities in the linac market (~70% still untapped), the potential of Varian’s software business, and how Varian can leverage Siemens’ scale and reach. Signify also touted this as a milestone in Siemens Healthineers’ 2025 strategy, noting that it shows progress towards the company’s second “upgrading” phase.
  • Ghost Imaging Movies: Israeli researchers demonstrated a new X-ray ‘Ghost imaging’ technique capable of unprecedented speed and resolution, which could allow clinicians to image rapidly moving biological processes. The researchers were able to produce an X-ray movie captured at 100,000 frames per second, suggesting that the technique could lead to new diagnostic applications, such as lower-dose high-resolution movies of the heart.
  • Otech’s CV19 Takeaways: Otech’s latest blog details how imaging succeeded and proved vulnerable during COVID-19 pandemic, providing insights into how the industry can prepare for the future. Otech’s COVID success stories involved hospitals quickly becoming more nimble / innovative, modality diversification (more bedside X-ray and POCUS), massive telemedicine growth, and more patients becoming health tech users (e.g. via telehealth platforms). However, the pandemic also exposed pre-existing challenges, as cyber security threats increased (due to work from home, telehealth), AI results remained mixed, digital pathology was a “major laggard,” and patient data access often proved inefficient / inconsistent.
  • InsideOut Imaging: Australian researchers developed a new GI image viewing system that allows patients to view and interact with videos of their gastrointestinal tract. The InsideOut system uses camera-attached medical imaging capsules to capture footage of a patient’s digestive tract and makes the footage available in three different real-time game-like videos, helping involve patients in their procedure and reduce their anxiety.
  • Surgery Delays Are OK: A new study in the American College of Surgeons suggests that women who had their breast cancer operations delayed by the COVID-19 shutdown are unlikely to have lower survival rates, as long as they had early stage cancer and were undergoing endocrine therapy. The study used data from nearly 379k women with early stage DCIS cancer or small invasive tumors and delayed their operations by up to a year. The women with small invasive tumors who delayed their initial cancer operations showed no signs that their cancers advanced to more severe stages, while women with ER-positive DCIS had slightly higher “upstaging” risks after 60 days, and women with ER-negative DCIS had higher “upstaging” risks after 120 days, noting that DCIS upstaging doesn’t affect survival.
  • Resident Pay Not OK: A new Medscape report revealed that radiology residents earn an annual average of $64,400, positioning them just above the overall average ($63,400) but below many other specialties like cardiology ($68,600) and plastic surgery ($69,500). Only 43% of residents felt that their pay is “fair” given their long hours, hefty school loans (nearly half have >$200k), and when they compare their pay to PAs and nurses.
  • NIH’s COVID Database: The NIH launched an initiative to create a massive open-source COVID-19 image database intended to help develop new imaging AI tools used to assess and manage COVID-19. The Medical Imaging and Data Resource Center (MIDRC) initiative is led by the NIH’s National Institute of Biomedical Imaging and Bioengineering (NIBIB) and will involve the major imaging societies (RSNA, ACR, AAPM) and the University of Chicago.
  • No Contrast for DTI: A new AJR study found that GBCAs don’t affect the diagnostic accuracy of breast diffusion-tensor imaging (DTI), suggesting that DTI does not require contrast enhancement. The study scanned 26 women (58% with cancer) with 3-T breast MRI with sequential DTI before and immediately after GBCA administration, finding that all breast cancers were visible before and after GBCA administration and mean tumor size was statistically similar with and without GBCA (17.3 mm vs. 15.3 mm).
  • United Imaging Adds MyoStrain: United Imaging announced a partnership with Myocardial Solutions that will allow United Imaging to offer Myocardial Solutions’ MyoStrain software on its uMR scanners (now FDA approved). MyoStrain is a MRI-based heart function test that quantifies the effects of disease, drugs, and ischemia across 48 heart segments in under 10 minutes, helping oncologists measure / manage the effect of cancer therapies on cardiac health.

The Resource Wire

– This is sponsored content.

  • Wondering what to look for in your next CT? This Hitachi blog goes beyond slice count, detailing the top three features that your next CT has to have. Here’s a hint: they will help you care for your >30% patients who are overweight.
  • Trying to figure out “Where do we go from here?” The first episode in Bayer Radiology and the AHRA’s COVID-19 rebound podcast series discusses workflow strategies as imaging centers reopen.
  • This GE Healthcare white paper details how its suite of point of care ultrasound AI tools simplify complex patient assessments, enable faster clinical decisions, and calculate precise results.
  • In this quick video, Einstein Healthcare Network’s Peter Wang, MD describes how Nuance’s embedded clinical guidance delivers streamlined radiology workflow and improves report quality.
  • They say that in times of crisis, you get to know who your real friends and partners are. This Q&A session details how Healthcare Administrative Partners stepped up to guide their client Triad Radiology Associates through the challenges presented by the COVID-19 pandemic.

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