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Nonphysician Expansion | COVID Brain Changes
March 9, 2022
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Together with
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“How about instead of AI that replaces radiologists, let’s start with one that auto-labels the spine?”
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A Tweet from Stephen Fisher, MD that led to a pretty helpful thread on what type of AI solutions radiologists are looking for.
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A new JACR study detailed nonphysician practitioners’ (NPPs) expansion across US radiology practices, mirroring a trend already seen in other parts of healthcare and raising questions about how much further radiology NPPs might expand.
The Study – The study reviewed 2017-2019 Medicare data for nurse practitioners and physician assistants (together “NPPs”) employed by US radiology practices, finding that:
- Radiology practices employing NPPs increased by 10.5% (228 to 252 practices), while the number of overall radiology practices declined by 36.5% (2,643 to 1,679)
- As a result, the share of radiology practices with NPPs on staff nearly doubled (8.6% to 15% of US practices)
- NPP-employing practices expanded their NPP workforce at a much faster rate (+17.5%, 588 to 691) than they added radiologists (+10.4%, 6,596 to 7,282)
- The growth of urban practices employing NPPs (10% to 17% share) significantly outpaced rural practices (5% to 7% share), despite a greater need for radiology coverage in rural areas
- Radiology practices were also more likely to employ NPPs if they were larger, staffed more interventional radiologists, or had a high number of early-career radiologists
The study was limited to radiology-only practices, which employ two-thirds of U.S. radiologists, but excludes many academic, hospital-employed, and multi-specialty groups. That said, it’s possible that radiology NPP growth would be even greater if these groups were included.
The Takeaway
Although 85% of practices didn’t employ NPPs and radiologists still outnumbered NPPs by a 32:1 ratio (as of 2019 anyway), this study reveals a clear trend towards more practices employing NPPs and rising overall radiology NPP headcounts. That’s probably not surprising given the historical growth of NPPs within other specialties, and radiology’s continued shift towards national and PE-owned practices, but it’s still interesting to see how it’s taking place.
It’s also interesting that this study wasn’t met with the level of radiologist uproar that we saw the last few times radiology NPPs made it into the industry news cycle. Even though NPPs’ expansion across radiology practices doesn’t mean that they will start encroaching into radiologists’ clinical territory (as some rads fear), it does suggest that we’ll see a lot more blended rad/NPP workforces going forward.
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The State of AI
Considering your short and long-term AI plan? Check out Canon Medical’s State of AI Roundtable, sharing insights into how imaging AI is being used, where it’s needed most, and how AI might assume a core role in medical imaging.
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Change Healthcare’s Secure Cloud
Did you know one quarter of healthcare organizations have experienced a cyber-attack in the last year? This Change Healthcare animation explains how 3rd-party certified cloud-native enterprise imaging can help secure IT infrastructure that might be exposed with re-platformed imaging systems.
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- COVID Brain Changes: A UK-based research team revealed that COVID can lead to substantial changes in brain tissues. The researchers examined brain MRIs from 785 individuals who were scanned before and after COVID’s peak (aged 51–81), including 401 people who contracted COVID between their two scans. The COVID group’s MRIs showed longitudinal reductions in gray matter in the orbitofrontal cortex and parahippocampal gyrus, tissue damage in regions associated with the primary olfactory cortex, and reductions in brain size. These declines were even evident when excluding the 15 patients who were hospitalized.
- Nuance’s Ambient Enhancement: Nuance Communications announced an upcoming expansion to its PowerScribe One reporting platform’s ambient AI capabilities, intended to streamline and enhance radiologists’ structured reporting output. The PowerScribe One platform’s Ambient Mode (currently used to create structured reports from free-form dictations) will add new Auto Impression functionality that turns report findings into auto-generated impression sections and follow-up recommendations.
- TB & LC Screening Alliance: Qure.ai, AstraZeneca, and global health non-profit PATH launched an alliance to expand lung cancer screening in low and middle-income countries. The partners will integrate lung cancer screening into tuberculosis screening pathways, leveraging Qure.ai’s algorithms for CXR-based lung disease detection, AstraZeneca’s lung cancer expertise, and PATH’s health program advocacy and execution. The partnership builds upon Qure.ai and AstraZeneca’s ongoing lung cancer screening alliance, and continues Qure.ai’s efforts to improve disease detection in developing countries.
- Liver Lesion Ultrasound AI: A new Radiology Artificial Intelligence study detailed an ultrasound AI model that was able to accurately detect and characterize focal liver lesions. The France-based team developed the model using B-mode abdominal ultrasound exams from 1,026 patients (2,551 images) and tested it with exams from 48 patients (155 images). The model matched or exceeded the performance of three clinicians (two experts) for detecting (90% specificity, 97% sensitivity), localizing (80%), and characterizing lesions as benign or malignant (81% specificity, 82% sensitivity).
- Enlitic Evidence: Fresh off revealing its pivot from traditional pixel-based diagnostic AI to a focus on standardizing radiology data, Enlitic provided the first evidence of how its Curie Standardize hanging protocol solution can help real world workflows. Over a three-year proof of concept study, UT Health San Antonio found that Curie Standardize would reduce its average CT (head, chest, abdomen) study organization time from 25 to 9 seconds. That adds up when multiplied over 480k annual studies, and as this recent radiologist Twitter discussion shows, it solves a problem multiple rads are looking for.
- FibroScan GO Launch: Echosens announced the launch of its FibroScan GO elastography-based liver screening system. The FibroScan GO is smaller and lower cost than Echosens’ other FibroScan devices, giving the company a more accessible solution for office-based practice settings and potentially allowing more PCPs to assess liver health (stiffness, fibrosis, steatosis) at the point of care.
- Neurosurgery MRI VR: An Italian research team developed an MRI-based mixed-reality solution that they believe might improve brain tumor removals and avoid damage to critical brain structures. The prototype solution automatically analyzes multimodal presurgical MRI scans (structural MRI, DTI, TOF) and transfers the results to a Microsoft HoloLens-integrated system, allowing neurosurgeons to utilize 3D holograms for planning and surgical navigation.
- DeepTek Funding: India-based AI startup DeepTek completed a $10M funding round that it will use to fund its global expansion, nearly 3.5 years after landing an early investment from NTT Data. DeepTek might not be a household name in the west, but its AI-integrated cloud PACS and AI-based population health screening products target two of the more intriguing radiology software categories.
- Ultrasound for SRM Surveillance: A study published in Urology suggests that ultrasound could be useful for active surveillance of small renal masses, potentially as an alternative to CT/MR cross-sectional imaging. Researchers analyzed data from 3,046 patients from 14 institutions who received ultrasound and cross-sectional imaging, and separated them into surgical (1,464 patients) and small renal mass cohorts (SRM, 1,582 patients, 1,921 imaging pairs). Among the SRM patients, 75% of the US and CT/MR measurements were within 0.5 cm and only 7.8% were different by more than 1 cm.
- Exo Works: Handheld ultrasound startup Exo announced the launch of its new POCUS workflow solution, Exo Works, intended to streamline patient data documentation and support collaboration, credentialing, and program tracking. Exo Works enables physicians to document, review, bill, and manage QA from their web-connected PCs or mobile devices and integrates directly with “virtually any” POCUS systems and most common EMRs and PACS systems.
- Cost of Incidentalomas: A new Clinical Imaging study revealed that the vast majority of a Dutch sarcoma center’s incidentalomas were later found to be “clinically irrelevant,” suggesting that the cost of detecting incidentalomas might rival the benefits. Incidentalomas were found in 28 of 221 patients (10.4%) who were referred to the specialized sarcoma center in 2018-19, but 23 of those were later labeled benign or low risk (82% of incidentalomas). These “irrelevant” incidentalomas led to multiple downstream medical procedures, resulting in an average cost of €1,857 per case (not to mention additional psychological distress).
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RMI Sees Clearly and Decides Confidently with ClearRead CT
See how adopting ClearRead CT allowed Michigan’s Regional Medical Imaging’s radiologists to complete their chest CT reads faster and more accurately in this Riverain Technologies case study.
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- Are you sure your imaging archive is safe and recoverable? See how Intelerad’s Cloud DR disaster recovery solution mitigates the many risks facing your archive by securely storing copies of every image.
- Women’s imaging has come a long way, but operational efficiency remains a challenge for many facilities. To help address this challenge, this Fujifilm post details the five questions women’s imaging facilities should ask when evaluating workflow management solutions.
- Join Nuance today, March 10th at 5pm ET, to discover how to close the loop on patient follow‑up and implement a comprehensive lung cancer screening program.
- Can culture be the foundation of your strategy? See how adopting a culture-led strategy has become an advantage for United Imaging and its clients in this essay by CEO, Jeffrey Bundy.
- Creating your AI adoption plan? This Arterys report details what clinical, efficiency, and regulatory factors to look for in radiology AI vendors.
- Evaluating your patient engagement strategy? Check out this Imaging Wire Show featuring Novarad’s Paul Shumway for a great conversation about how new technologies are helping imaging providers safely and securely improve patient engagement.
- See why GE Healthcare’s new StarGuide SPECT/CT is a “breakthrough in the world of SPECT” in this interview with the Hospital of Orleans’ key nuclear medicine stakeholders.
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