US-Guided Breakthrough | No Patients on the EHR | No Non-Radiologists

“This technology is essentially producing the world’s most advanced selfie, and the benefit is that there’s nothing dangerous about it.”

Hospital for Special Surgery’s Howard J. Hillstrom, PhD on how 3D surface imaging system could serve as an alternative to X-ray for scoliosis imaging.

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  • Carestream – Focused on delivering innovation that is life changing – for patients, customers, employees, communities and other stakeholders
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  • Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time
  • Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter
  • Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation genuine AI technology to disrupt the industry
  • Qure.ai – Making healthcare more accessible by applying deep learning to radiology imaging

The Imaging Wire

Ultrasound-Guided Biopsy Breakthrough

Researchers at Germany’s Fraunhofer Institute developed a new MR-compatible ultrasound system that could reduce reliance on MRI for biopsy procedures. Here are some details:

DiPhAS KoMBUS – The DiPhAS KoMBUS system (includes: MRI-compatible monitor, two US transducers, and a MR-compatible multichannel ultrasound) allows initial MRI images to be used in combination with real-time ultrasound scans throughout biopsy procedures (vs. repeated MRI scans).

Benefits – This new approach significantly reduces biopsy procedural time/discomfort and lowers MR imaging costs compared to traditional MR-based biopsy needle guidance.

Next Steps – After successful tests on a phantom model, the DiPhAS KoMBUS system is expected to begin clinical trials within the next few months.

No Patients on the EHR

We can add patients to the list of folks who aren’t big on using EHR systems, as a new study published by Health Affairs finds that only about 10% of patients with access to their electronic medical records use it.

The Study – A Portland-based team reviewed data from 2,410 U.S. hospitals between 2014 and 2016, finding that although 95% of hospitals allowed patients to view/download/transmit their electronic health information only 10% of those patients actually accessed their data. Access rates were highest among system-member, teaching, and for-profit hospitals, while hospitals in disadvantaged areas had lower access rates.

Significance – Given that one of the goals for EHRs was to help patients become better informed healthcare consumers, this study shows that patients either aren’t aware of their EHR access or not interested (or a mix of both). In other words, policy efforts to get patients to digitally engage with their healthcare data has failed, particularly among patients in disadvantaged groups/areas.

Suggestions – The researchers found that “there is significant room for improvement” in how we get patients to engage with their EHR data, suggesting that policy makers should consider new incentives and changing requirement thresholds for the Promoting Interoperability Program.

Microfractures Imaged

A University of Maryland Baltimore and University of Illinois-based team is developing a breakthrough spectral CT technique that uses nanoparticles to image bone microfractures. Here are some details:

Hafnium Breakthrough – The team developed hafnium-based nanoparticles that navigate and attach to bone microfractures, which are then imaged using spectral CT technology developed by Kiwi imaging startup MARS. This represents a significant milestone for microfracture imaging and spectral CT technolgy, especially given that traditional X-ray and CT are unable to effectively image microfractures.

Next Steps – The team is working to confirm that hafnium-based spectral CT imaging is safe for humans (it’s already been proven to excrete safely) and they may begin testing the microfracture imaging application on humans as early as 2020. They are also considering what other healthcare applications may benefit from spectral CT’s ability to image soft tissue in color (e.g. heart blockage) as they expand beyond microfracture imaging.

No Non-Radiologists

“Besides radiologists and cardiologists, no other medical specialty provides sufficient education for their trainees and practitioners in advanced imaging interpretation to justify allowing them to interpret these studies in practice, except under carefully controlled circumstances.” This is the conclusion from a new AJR study that likely has radiologists across the country nodding their heads:

The Study – A Thomas Jefferson University team studied advanced imaging interpretations (CT, MRI, PET, and general nuclear imaging) from 2015 to compare procedure volumes of radiologists and non-radiologist physicians and evaluate whether non-rads could be adequately trained to read these studies.

Results – As expected, radiologists performed the vast majority of CT (99.29%), MRI (99.04%), and PET (94.19%) interpretations, while general nuclear medicine studies were more evenly split between radiologists and non-radiologists (63.14% vs. 36.86%). Cardiologists read the most advanced imaging studies with 3% of all interpretations.

Implications – Given the lack of CT and MRI training available to non-radiologists, the ACR’s requirement that non-radiologist physicians complete 500 CT and MRI reads under supervision to interpret these modalities, and non-rads’ lack of exposure to advanced imaging, the researchers don’t believe non-radiologists will (or should) interpret more advanced imaging studies in the future .

The Wire

  • GE Healthcare launched its new Edison Datalogue enterprise data management solution intended to connect healthcare data systems, devices, applications, and clinicians. Targeting the data silo challenges resulting from ongoing healthcare system consolidation, Edison Datalogue is built around GE’s VNA with added analytics and collaboration tools to support data and image sharing across a care delivery network.
  • Mayo Clinic researchers found that a proprietary image-processing algorithm could allow lower-dose and faster molecular breast imaging (MBI) examinations. After reviewing 50 standard-dose MBI images, 50 simulated half-dose MBI images, and 50 half-dose MBI images that were enhanced with the image-processing algorithm, two breast radiologists found that lesion conspicuity in the algorithm-enhanced half-dose images were equal to or better than the standard-dose images.
  • RadNet announced a partnership with AI firm, Whiterabbit.ai, that will initially focus on a patient outreach solution intended to improve breast cancer screening compliance. After completing a successful pilot program in Delaware and Florida, RadNet officially licensed Whiterabbit.ai’s breast cancer screening attendance platform, revealing plans to deploy the solution across all RadNet markets in H1 2020 and co-develop other solutions in the future. Radnet also made an unspecified investment in Whiterabbit.ai, representing another next step in its efforts to bring more of its AI development in-house after fully acquiring Nulogix in August.
  • A UW Madison team is developing a wearable ultrasound device intended to improve respiratory function monitoring during anesthesia, potentially replacing or joining the current process that uses indirect metrics to monitor breathing (heart rate, blood pressure, and oxygen) and might not signal a respiratory problem until well after a patient entered a low-oxygen state. The wearable system uses ultrasound pulses to measure changes in respiratory rates in patients’ windpipes and provides immediate alerts when breathing changes occur.
  • A recent fastcompany.com article detailed the emergence of precautionary brain aneurysm screening in Japan, warning that even though it may become available in other regions doesn’t mean that regular brain screening is good for you. The physician-written article noted that there aren’t standards for aneurysm screening, that the ACR advises against head and neck imaging without serious symptoms, and warned of the risks of incidentaloma, but did note that aneurysm screening may be of value for certain high-risk patients.
  • Hospital for Special Surgery researchers are exploring whether automatic 3D surface imaging maps can be used to calculate spine curvature, reducing radiation from ongoing x-ray use, reducing false positives, and improving therapy guidance. The maps are created with 3dMD’s 3D surface imaging system, which captures patients’ shape with 30 surface cameras using stereophotogrammetry, and supports detailed analysis since its a mathematical depiction of the surface of the patient. The team’s upcoming study will combine 3dMD mapping with EOS imaging’s dual plane x-ray to evaluate the 3D surface imaging technique’s role in scoliosis screening and potentially create an algorithm that estimates spine curvature without x-ray imaging.
  • Laurel Bridge Software announced its new AI Workflow Suite, intended to help healthcare providers and AI developers to integrate on-premises and cloud-based AI algorithms into clinical workflows. The suite uses a number of tools to identify, fetch, anonymize, and deliver current and relevant prior studies to AI algorithms and post-processing applications and then deliver the results to PACS, VNA, and EMR platforms.
  • The Keystone Health Information Exchange (KeyHIE) and Life Image launched a FHIR-based imaging app that allows KeyHIE’s 350 facilities to share medical images and reports with patients through a provider portal. Life Image developed this first-in-the-nation tool using the SMART on FHIR standard and Life Image’s own Instant Access apps, allowing online image viewing and streamlining access for patients and clinicians.
  • French computer-assisted interventional radiology firm, Imactis, expanded to the U.S. for the first time through a deal to provide UW Health with its CT-Navigation system. The Imactis CT-Navigation system includes a navigation station and an instrumentation kit for CT-guided percutaneous interventional radiology procedures (tumor ablations, biopsies, musculoskeletal interventions, and other needle-based interventions), achieving a 50% improvement in target accuracy and a 63% reduction in radiation exposure.

The Resource Wire

  • This Carestream Special Report details how providers can get the greatest ROI from their X-ray technology as radiography demands increase and budgets head the other direction.
  • U.S. News’ recent “Medical Marvels” article told the story of five patients who addressed their chronic pain through focused ultrasound therapy.
  • Yale University research reveals that the average patient drives past SIX lower-cost providers on the way to an imaging procedure, due in large part to patients’ and physicians’ limited cost consciousness. Medmo helps address this issue by letting patients enter what they can afford for their scan, then booking them at a nearby imaging center willing to accept that rate.

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