maiData CEO, Julian Marshall, betting that AI won’t ‘cross the chasm’ until after 2026.

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Radiology Practices

Radiology’s Nonphysician Service Expansion

A new Harvey L. Neiman study showed that the recent expansion of nonphysician practitioners (NPPs) across US radiology practices coincided with similar increases in NPP-billed services — services that have traditionally been performed and billed by radiologists.

The Study – Researchers reviewed 2017-2019 data for Medicare claims-submitting nurse practitioners and physician assistants (together “NPPs”) who were employed by US radiology practices, finding that:

• The number of radiology-employed NPPs who submitted claims increased by 16.3% between 2017 and 2019 (523 to 608 NPPs), while the number of US radiology practices that employed claims-submitting NPPs jumped by 14.3% (196 to 224 practices)

• This NPP service expansion was driven by clinical evaluation and management services (E&M; +7.6% to 354), invasive procedures (+18.3% to 458), and image interpretation services (+31.8% to 112).

• Meanwhile, total NPP wRVUs increased by 17.3%, similarly driven by E&M services (+40% to 111k wRVUs), invasive procedures (+5.6% to 189k), and image interpretation (+74% to 8,850 wRVUs)

• Some radiologists might be concerned that image interpretation saw the greatest NPP headcount and wRVU growth (see +31.8% & +74% stats above), although imaging only represented a small share of overall NPP wRVUs (2.9% in 2019), and 86.7% of NPP-submitted imaging services were for either DEXA scans or swallowing studies. 

The Takeaway

Although roughly 87% of radiology practices still don’t employ NPPs who submit Medicare claims (as of 2019 anyway), this study reveals a clear trend towards NPPs performing more billable procedures — including image interpretation. 

Given previous evidence of NPPs’ growing employment in radiology practices and the major role NPPs play within other specialties, this trend is very likely to continue, leading to more blended radiology teams and more radiologist concerns about the NPP ‘slippery slope.’

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The Wire

• GE & Enlitic Standardize: Enlitic will make its AI-based Curie platform available within GE Healthcare’s PACS workflows, allowing GE users to reduce non-diagnostic disruptions caused by broken hanging protocols. As its name suggests, Enlitic’s Curie Standardize application standardizes DICOM descriptions before PACS transmission, ensuring correct/consistent image labels and hanging protocols. The alliance is notable for both companies, connecting Enlitic with another major PACS partner (joining Sectra), while giving GE a solution that directly contributes to its radiology efficiency strategy.

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• Arterys Adds Whiterabbit.ai: Arterys further expanded its Breast AI suite, adding Whiterabbit.ai’s ACT mammography screening compliance software to its broad iCAD-based Breast AI portfolio. Through the distribution agreement, Arterys’ customers will be able to integrate Whiterabbit.ai ACT into their compliance screening programs, using ACT to provide patients with screening recommendations and notifications, while evenly distributing clinics’ screening appointments throughout the year. 

• Detecting AFib with CTA: A new study in European Radiology suggests that carotid CTA-based bolus-tracking data could be used to detect atrial fibrillation. Using data from 716 patients who underwent carotid CTA and a 24-h Holter test (80 w/ Afib), the researcher found that Afib patients had significantly longer total bolus-tracking times (TTT; 23.8 vs. 18.7 seconds) and significantly lower bolus-tracking graph average slopes (AS; 0.8 vs. 1.38). TTT was also associated with a significantly higher risk of Afib and left atrial pressure (odds ratios: 1.36 & 1.46).

• Fixed XR & Fluoro’s 2021 Rebound: Signify Research reported strong 2021 rebounds in the global fixed digital radiography (+15% to $1.2B) and fluoroscopy markets (+18% to $509M), following sharp COVID-related declines in 2020 (-14% & -19%). Signify expects demand for fixed X-ray systems to continue to recover as postponed projects restart, while fluoroscopy growth slows after 2022 as traditionally fluoro-based procedures shift to other modalities.

• ACR Speaks Out on PCP QPAs: The ACR voiced its opposition to insurers’ use of primary care providers’ contracted rates when calculating qualified payment amounts (QPA) for specialty out-of-network care (e.g. radiology or anesthesiology), suggesting it might violate the No Surprises Act. An ACR co-commissioned study found that PCP contracts include services that primary care practice employees “rarely” or “never” provide (n=75; 68% & 57%), potentially leading to QPA calculations that do not reflect real-world rates.

• AIRS’ Series B: South Korean AI startup AIRS Medical secured $20M in Series B funding (total funding now $23.9M) that it will use to expand its SwiftMR deep learning MRI reconstruction solution globally. SwiftMR has regulatory approval in the US and South Korea, and is already being used in 30k MRI exams per month in South Korea.

• CTPA Texture PE Assessments: A new Angiology study found that CTPA texture analysis (analyzes thrombus textures and identifies biomarkers) could help clinicians assess patients with acute pulmonary embolism. The 216-patient study revealed an association between certain texture features and mortality (p < 0.001) and other textures with patients’ sepsis-related organ failure score (p < 0.001). The authors also noted significant texture differences among PE survivors and nonsurvivors as well as patients who needed ICU care and those who didn’t (p = 0.02 & 0.02).

• GE & Boston Scientific’s India Collab: Boston Scientific and Wipro GE Healthcare (GE’s India-based joint venture) launched an interventional cardiology partnership in India. The new partnership combines Boston Scientific’s interventional cardiology portfolio with GE’s cardiac and interventional imaging systems, and will involve joint training and education efforts. It appears that this is part of a global initiative, as the companies recently launched a similar partnership in Southeast Asia. 

• Curbing Brain CT Volumes: A new study in Current Problems in Diagnostic Radiology showed that imaging utilization policy interventions can indeed help slow volume growth. The researchers found that Medicare-covered brain CT volumes maintained a 3.2% CAGR between 1994 and 2018 (8,728 to 19,287 per 100k), while Medicare denial rates for brain CTs fell by 54.5% between 1999 and 2005 (12.3% to 5.6%). However, brain CT volume growth and brain CT denial rates both stabilized after 2005 following “multiple policy interventions aimed at decreasing Medicare medical imaging cost and volume.”

• EchoNous & Samsung Tablets Connect: A new alliance between Samsung and EchoNous allows clinicians to use the Kosmos handheld ultrasound system with Samsung’s Galaxy Tab Active Pro tablets, rather than being bound to EchoNous’ Kosmos Bridge display. The new compatibility will lower the Kosmos platform’s overall cost, which is already “tens of thousands of dollars less” than cart-based competitors.

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The Resource Wire

• Imaging providers who want to finally #ditchthedisk can now start off with Novarad’s CryptoChart Lite solution, a standard version of CryptoChart built for providers transitioning to imaging sharing.

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• When Sao Paolo’s Diagnosticos da America SA (DASA, the world’s 4th largest diagnostics company) set out to evaluate Qure.ai’s QXR solution for their pediatric chest X-ray workflows, they leveraged CARPL.ai’s platform to streamline their evaluation. See how it worked here.

• 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.

• Is your MRI fit for the future? See how upgrading to Siemens Healthineers’ BioMatrix scanner can allow you to meet rising demand and improve your MRI workflows without the costs and disruptions of moving to a completely new MRI.

• Faced with growing subspecialty volumes, Diversified Radiology of Colorado adopted Intelerad’s InteleOne XE enterprise workflow solution to ensure all appropriate cases are read by subspecialists, while reducing its average TAT to under 17 minutes.

• Check out this Imaging Wire Show featuring Arterys’ Director of Product Management, Maya Khalifé, PhD, discussing how to deliver clinical value with AI, Arterys’ platform approach to neuro AI, and how AI can serve radiologists today and into the future.