Matthew Fuld, PhD on the impact of Siemens Healthineers’ new NAEOTOM Alpha Photon-counting CT.

I’m happy to share the latest Imaging Wire Show featuring Siemens Healthineers’ Matthew Fuld, PhD. Join us for this deep dive into the upcoming Photon-counting CT revolution.

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Imaging Centers

UnitedHealthcare’s Imaging Designation

UnitedHealthcare continued its war against imaging costs, introducing its new Designated Diagnostic Provider program. This program is built to drive more exams through providers that meet UnitedHealthcare’s definition of quality and cost, and could have a big impact on its imaging partners.

Designated Criteria – Hospital outpatient and freestanding imaging centers that are contracted with UHC to provide advanced imaging (MRI, CT, PET, MRA, nuclear) must apply to receive Designated Diagnostic Provider status. Imaging providers who don’t meet UHC’s cost / quality criteria will be instructed to make specific improvements or settle for “non-Designated” status (they’ll still be in-network).

Patient Incentives – UnitedHealthcare patients referred for advanced imaging will be automatically sent to Designated Diagnostic Providers, and will face far higher co-pays if they somehow find a non-Designated imaging center (e.g., $680 vs. $290 for a CT).

Designated Dilemma – UnitedHealthcare’s contracted imaging providers will now either have to adopt what are surely UHC-friendly policies, or brace for a lot less UHC patients. These Non-Designated Providers would also have to be okay with charging UHC patients far higher co-pays than if they went to a Designated Provider.

UHC’s Outpatient Push – UnitedHealthcare has been aggressively shifting patients away from hospitals and towards outpatient imaging centers for quite a while, and this latest move ensures that most of these outpatient exams will happen at its preferred imaging centers. 

The Takeaway
One of the ways UnitedHealth Group achieved its massive growth was by steering patients to the highest-value procedures and treatments. The new Designated Diagnostic Provider program seems like a very effective way to apply that strategy to medical imaging coverage, even if many imaging providers might not like it.

HUMC’s Case for Siemens Healthineers TrueV

When the demand for your PET/CT imaging services outpaces available appointments, what are your options? Learn how Hackensack University Medical Center optimized its clinical operations by upgrading its Biograph Horizon to TrueV technology in this new case study from Siemens Healthineers.

Lung Cancer Programs: Go, Grow and Flow

Over 9 out of 10 people who should be screened for lung cancer aren’t, and nearly 50% of lung cancer cases are caught in the advanced stages. We know from prostate and breast cancer screening that clear guidelines and increased screening saves lives. But lung cancer screening has been challenging. Riverain strives to make everything about the lungs clearer, so they assembled this resource page for anyone interested in starting or improving their lung screening program.

The Wire

• Xenon MRI for Long COVID: UK-based researchers discovered that Xenon gas-enhanced MRI could help scientists understand and develop new treatments for long COVID-related breathlessness. The researchers performed Xenon MRI, CT, and lung function tests on 35 individuals (11 w/ long COVID but never hospitalized, 12 w/ long COVID who were hospitalized, 13 controls). They found that Xenon gas transferred less effectively among the long COVID patients, even though their CT scans didn’t show lung abnormalities and their lung function tests matched the controls.

• An Exchange Ultimatum: A JACR editorial by some of medical imaging’s biggest influencers called for image exchange companies to start working together or face consequences. The authors blamed competitive motives (not technology factors) for the fact that images are still mainly exchanged via physical media, proposing a vendor-to-vendor exchange model to solve this problem. They also asked exchange vendors to “immediately commit” to this model, while encouraging healthcare institutions to only contract with committed exchange vendors by 2024.

• Lung-RADS Underestimates: A new AJR study revealed that Lung-RADS category 3 and 4 nodules might be more prevalent and have higher malignancy rates than current ACR estimates suggest. The researchers reviewed 9,148 LCS exams, finding that a far higher percentage of patients had category 3 (9.4% vs. 5%) and category 4 nodules (7.9% vs. 2%) than the ACR Lung-RADS estimates. These patients also had far higher malignancy rates for category 3 (3.9% vs. 1-2%), 4A (15.5% vs. 5-15%), 4B (36.3% vs. >15%), and 4X nodules (76.8% vs. >15%) than the Lung-RADS estimates.

• AI in the NHS: The UK NHS provided an interesting breakdown of its AI use, while highlighting imaging’s central role in its AI rollout. Of the NHS’s 240 active AI technologies, Diagnostic AI tools were the most prevalent ‘type’ (34%), radiology and cardiology were the top two ‘clinical areas’ (11% & 9%, after ‘multiple’ at 23%), and radiology, radiographers, and cardiology were among the ‘most affected workforce groups’ (15%, 8%, 8%). 

• Butterfly & Ambra Integrate: Butterfly Network and Ambra Health will launch an integrated solution, combining Butterfly’s Blueprint enterprise platform with Ambra’s image management technology. The solution would bring POCUS exam data into clinical workflows, representing a significant expansion for a modality that has “point-of-care” in its name.

• Info-Blocking Influx: Current Problems in Diagnostic Radiology once again lived up to its name, detailing how complying with the 21st Century Cures Act’s information-blocking rules can lead to a surge in questions to referring physicians. A survey of 249 MGH referring physicians found that the majority were contacted by patients about their radiology reports (195, 78%) and received a higher volume of patient calls (165, 66%) during the 60 days after MGH began giving patients immediate access to their radiology reports.

• Vara & Mamotest’s Mexico Venture: Vara and Mamotest launched a breast cancer screening alliance in Mexico that combines Vara’s mammography AI with Mamotest’s tele-mammography service, and could significantly improve breast screening accessibility in the country (~$15 vs. ~$100 normally). The partners launched their first breast screening unit in Reina Madre private hospital near Mexico City and plan to open “many” other units across Mexico. This is a great example of how AI can make an impact in countries without formal screening infrastructure.

• Public Dataset Disparities: The publicly available CXR datasets that we cover in AI studies nearly every week might contain significant demographic imbalances. That’s from a recent JACR study review of 23 public CXR datasets, finding only 13 datasets detailing patient gender, just two reporting patient race or ethnicity, and only one citing coverage status. Across the dataset with gender details, there were far more CXRs from male patients (avg: 55.2%; range: 47.8%-69.7%).

• Five Years for Kickbacks: California imaging center CEO, Sam Sarkis Solakyan, found out the hard way that crime doesn’t pay (at least not in the long run) after being sentenced to 5 years in prison and ordered to pay $28M for operating an MRI “cross-referral scheme.” Solakyan paid recruiters and clinicians over $8.6M to refer workers comp patients to his nine imaging centers where he generated over $250M in kickback-related imaging procedure billings.

• Cautiously Optimistic & Needing Education: A new JMIR study of 2,167 Canadian healthcare students (10 fields, 18 universities) revealed that most students expect AI to have a major impact on their careers (78.7%) and are cautiously optimistic about AI’s role in their fields (74.5%). However, only half of the students knew what AI was (49%) and even fewer had an accurate understanding of AI (31%). We’ve seen similar AI opinion surveys, although this study’s diverse student population is notable (included: dentistry, nursing, dietetics, others) considering that many see radiologists as just the first step towards enterprise AI adoption.

• VIA Acquires: Alabama-based practice Vulcan Imaging Associates (>30 radiologists, founded in 1969, serves AL, GA, FL) expanded its breast imaging capabilities with its acquisition of local tele-mammography practice, Women’s Imaging Associates. This is one of the smaller practice acquisitions we’ve covered, but it still helps solidify VIA’s presence and capabilities.

Unleash the Power of the Cloud

Change Healthcare’s cloud-native, zero-footprint Stratus Imaging PACS is now live in clinical use. See how Stratus Imaging PACS is helping radiology practices improve productivity and patient care, while eliminating the cost and resource constraints of on-premise systems.

The Resource Wire

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

• Have more echo studies than sonographers? See how Us2.ai was able to classify, segment, and annotate echocardiographic videos with similar accuracy as expert sonographers. 

• Signs point to a new trend in MRI: an era of step-change that will fundamentally lower barriers to accessing technology and exams. Read United Imaging’s CEO Jeffrey Bundy’s article about the three activities at the crest of his disruptive wave. 

• In this quick video, Sharp Memorial Hospital interventional radiologist, Jim Lyon, MD, describes the image quality and dose advantages of Canon Medical Systems’ Alphenix Sky+ system.

• Trying to figure out how your IT resources can handle increased AI adoption? This Blackford paper details how the cloud is helping radiology organizations scale their computing resources to support multiple AI applications or algorithms.

• This Bayer Radiology white paper details how the right people, plan, and systems can help imaging teams achieve their dose management goals.

• See how New Jersey’s Ramapo Radiology Associates overcame their CD burning problems and improved their physician and patient experiences with Novarad CryptoChart.

• This American College of Cardiology case report details how Arterys’ 4D flow enhances visualization of blood flow and pulmonary venous anatomy in cardiac MRI, improving diagnosis and surgical planning for partial anomalous pulmonary venous return.

• Evaluated CVIS platforms? This Fujifilm Healthcare report outlines the criteria providers should consider for their image and reporting platforms, and how the Fujifilm VidiStar platform’s features, service, and vendor collaboration meet providers’ needs.

• Check out this Imaging Wire Show, featuring Nanox AI strategy leader, Dr. Orit Wimpfheimer, where we discuss building an international telerad practice, what’s wrong with triage AI, and pivoting to population health AI.

• In this Nuance Q&A, Open System Imaging’s medical director and CTO discuss how adopting PowerScribe One improved the California radiology practice’s efficiency and productivity.