Snap Diagnosis | CMS Cuts | ED Down

“Snapchat may have a role in the digital radiologic classroom’s evolution,”

An LSU study with solid evidence that Snapchat actually outperforms the current radiology classroom tech.

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Imaging Wire Sponsors

  • Bayer Radiology – Providing a portfolio of radiology products and solutions including contrast media, medical devices, dose management software 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

Snap Diagnosis

Social media platforms come and go (even if they don’t get banned), but Snapchat could prove to be a longer term radiology teaching tool. That’s from a new LSU Health New Orleans School of Medicine study and here are the details:

  • The Study – Seven radiology residents reviewed five emergency radiology cases using Snapchat and five similar cases using a classroom projector. Their diagnoses were compared against reads from two attending radiologists and scored on a 0-2 scale (0 = complete miss, 1 = major finding, but missed diagnosis, 2 = correct diagnosis).
  • The Results – The students’ diagnoses based on the Snapchat images were far superior to the classroom projector cases, with the junior residents scoring 81/160 on Snapchat (vs. 63/160 via projector) and the seniors scoring 88/120 (vs. 75/120 via projector).
  • The Takeaway – The authors suggest “Snapchat may have a role in the digital radiologic classroom’s evolution,” especially for emergency radiology training. Even if the actual Snapchat platform doesn’t make it into radiology education, the aspects that made these Snapchat-based reads so much more accurate are worth considering. The same goes for whatever made projector-based reads so much less accurate.

CMS Cuts

Radiology ended up on the wrong side of CMS’ proposed 2021 Medicare payment changes, which could reduce radiology and IR reimbursement rates by 11% and 9%, and potentially cost radiology-related specialties $10b through 2030.

  • Zero Sum Reimbursements – The MIPS reductions, which also hit specialties like emergency medicine (-8%) and anesthesiology (-8%), are largely due to changes to Evaluation and Management (E/M) reimbursements and CMS’ required budget neutrality. With the new structure, the E/M changes create $5b in additional provider reimbursements (largely for prolonged/complex office visits) and will therefore require cuts to other specialties.
  • HOPPS Costs – CMS also proposed changes to the Hospital Outpatient Prospective Payment System (HOPPS) that could reduce reimbursements for CT and MRI exams. CMS proposed increasing the HOPPS conversion factor by 2.6% to $80, regardless of how hospitals allocate CT and MR cost data, including by square foot (vs. ‘direct’ or ‘dollar’) which could underestimate true CT and MRI costs. The new HOPPS draft also reduces payments for low-dose CT lung cancer screening and for visits to determine lung LD-CT eligibility.
  • ACR Disappointment – The ACR quickly voiced its disappointment with the proposal, particularly the changes to E/M coding, which it has been lobbying against for some time. The ACR vowed to continue its fight and it isn’t the only association that’s upset, so we can expect a fight over the coming months.

The Wire

  • Radiologish to English: Dr. Hugh Harvey of Hardian Health just launched a radiology report-to-layperson translator that converts radiologists’ “esoteric” report language into something that a layperson could understand. The publicly available tool received a warm welcome on radiology Twitter and is a solid example of how an AI tool can aid radiology even if it doesn’t interpret images.
  • Hologic Campaigns: Hologic launched its ‘Back to Screening Campaign,’ offering women a chance to attend a COVID-friendly virtual performance from Sheryl Crow by signing up to receive annual mammogram screening reminders. Hologic is the first manufacturer we’ve seen to go out and encourage screenings like this, but it joins a number of major hospital groups and medical associations asking patients to come back after delaying screenings throughout the shutdown.
  • Pediatric Shifts: A new JAMA Network study (n = 26m ED visits, 9.86m children) found that pediatric emergency departments increased their advanced imaging usage from 6.4% of encounters in 2009 to 8.7% in 2018. The study revealed notable ultrasound (2.5% to 5.8%) and MRI increases (0.3% to 0.6%), coupled with significant CT declines (3.9% to 2.9%), that the study attributed to a combination of new guidelines, new tech, and increased US/MRI availability.
  • Ireland’s Old CTs: At least 15 of Ireland’s 59 operating CT scanners have surpassed their life expectancy dates (most expired in 2016 or 2017) and another two will reach end-of-life this year. Ireland plans to add six new CTs in 2020, but the country’s Sinn Fein political party is calling for more widespread updates, warning that the older systems are less dependable and could create future delays in healthcare delivery.
  • CV19 and LUS Growth: A new study in the Journal of Ultrasound in Medicine revealed that the COVID-19 pandemic drove increased lung ultrasound use in Italy. The May 2020 survey (n = 123 Italian Ultrasound Society members) found that daily LUS exams increased by 250% during the pandemic, with much of this growth driven by experienced LUS users, while 14.6% of the respondents began using LUS for the first time during COVID. The crisis also brought increased equipment demand, as 53% of respondents acquired new ultrasound systems.
  • JLK & Doctor Net: South Korean AI developer JLK Inspection and Japanese teleradiology leader Doctor Net announced a new partnership that will make JLK Inspection’s image reading algorithms (lung, brain, and prostate) available through the Doctor Net platform.
  • CV19 Impact & Relief: An ACR and RBMA survey (n = 228) provided new details into how the COVID-19 pandemic affected radiology practices. The survey confirmed previous imaging volume decline estimates (down 56.4% – 63.7% overall), noting that outpatient settings were hit the hardest, and revealing that nearly 70% of practices applied for financial relief programs (yes, that many).
  • Intelerad Buys Radius: Intelerad made its first big acquisition since becoming part of UK PE firm HG, acquiring radiology cloud platform provider Radius, LLC. The addition of Radius’ cloud tech and client base (15 of which the companies share) will add to Intelerad’s nuage cloud offering, expand its managed services capabilities, and bring it closer to its goal of becoming “a true one stop shop” for imaging IT. Radius already provided cloud services to Intelerad’s customers through a partnership that launched five years ago.
  • ED Down, Admissions Up: A new JAMA study revealed that the COVID-19 pandemic led to a major drop in ED visits, but an increase in hospital admission rates, suggesting that providers and public health officials should encourage patients to visit the ED whenever necessary. Looking at January to April data from five states, the study found that ED visits dropped by between 41.5% and 63.5%, while hospital admissions increased by between 22% and 149%. The steepest ED decreases occurred in March, while the admission increases spiked as each state hit its peak in COVID cases.
  • Philips & Imricor: Philips began a collaboration with MRI-guided cardiac ablation company, Imricor Medical Systems that will give Philips non-exclusive rights to re-sell Imricor’s Advantage-MR System configured with Philips’ MRI scanners in Europe. This collaboration is the latest chapter in Imricor and Philips’ collaboration, which has worked with Philips to build iCMR labs since 2010, but it’s the first time Imricor relied on an OEM as a channel partner.
  • CORADS-AI: A study in RSNA’s Radiology journal highlighted the accuracy of new CORADS-AI algorithms (three algorithms, developed w/ 520 CT scans), which can help assess and diagnose COVID-19 using non-contrast CT scans. In a comparison against eight radiologists, the algorithms correctly predicted 81% of CO-RADS scores and produced CT severity scores within one point per lobe in 94% of patients. CORADS-AI also differentiated CV19-positive and negative patients with a 0.95 AUC using internal data (n = 105) and a 0.88 AUC using external data (n = 262).
  • Breast MRI Attachment: Russian researchers developed an MRI technique that transforms any standard MRI system into a breast MRI system, without requiring higher-cost coils. The concept design uses special ceramic resonators that focus MR imaging at the patient’s target areas.
  • Siemens SOMATOM On.site: Siemens Healthineers announced the FDA approval of its SOMATOM On.site mobile head CT, making Siemens the most prominent OEM in the head CT segment. The SOMATOM On.site is intended to provide bedside scans in the ICU, significantly reducing the time (~1hr) and staff (up to 5 people) traditionally required to transport patients to a CT scanner.

The Resource Wire

– This is sponsored content.

  • In this Bayer Radiology video, East Texas Medical Center Radiology Director, Bill Tobin, details how they used Bayer’s MEDRAD Stellant Smart Injector and contrast dose management to reduce contrast volumes and repeat scans.
  • This Nuance case study details how PowerShare Image Sharing helped Navicent Health cut its mammography reporting time by 38%.
  • 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.
  • This Hitachi post details how human centered design led to the Scenaria View CT’s innovative Lateral Shift Table, which increases spatial resolution, allows accurate centering, and reduces dosage.
  • This Riverain Technologies case study details how Einstein Medical Center adopted ClearRead CT enterprise-wide (all 13 CT scanners) and how the solution allowed Einstein radiologists to identify small nodules faster and more reliably.
  • The introduction of ultrasound into musculoskeletal care has been a game-changer, revolutionizing the level of precision MSK physicians can bring to patient care. This GE Healthcare profile details how one physician used point of care ultrasound to help improve performance and effectiveness.

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