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Artificial Intelligence

Prioritizing Length of Stay

A new study out of Cedars Sinai provided what might be the strongest evidence yet that imaging AI triage and prioritization tools can shorten inpatient hospitalizations, potentially bolstering AI’s economic and patient care value propositions outside of the radiology department.

The researchers analyzed patient length of stay (LOS) before and after Cedars Sinai adopted Aidoc’s triage AI solutions for intracranial hemorrhage (Nov 2017) and pulmonary embolism (Dec 2018), using 2016-2019 data from all inpatients who received noncontrast head CTs or chest CTAs.

• ICH Results – Among Cedars Sinai’s 1,718 ICH patients (795 after ICH AI adoption), average LOS dropped by 11.9% from 10.92 to 9.62 days (vs. -5% for other head CT patients).

• PE Results – Among Cedars Sinai’s 400 patients diagnosed with PE (170 after PE AI adoption), average LOS dropped by a massive 26.3% from 7.91 to 5.83 days (vs. +5.2% for other CCTA patients). 

• Control Results – Control group patients with hip fractures saw smaller LOS decreases during the respective post-AI periods (-3% & -8.3%), while hospital-wide LOS seemed to trend upward (-2.5% & +10%).

The Takeaway

These results were strong enough for the authors to conclude that Cedars Sinai’s LOS improvements were likely “due to the triage software implementation.” 

Perhaps more importantly, some could also interpret these LOS reductions as evidence that Cedars Sinai’s triage AI adoption also improved its overall patient care and inpatient operating costs, given how these LOS reductions were likely achieved (faster diagnosis & treatment), the typical associations between hospital long stays and negative outcomes, and the fact that inpatient stays have a significant impact on hospital costs.

Canon Across America

Check out this Imaging Wire Show featuring Canon Medical Systems’ David Hashimoto, exploring how Canon is connecting with imaging teams and working to address their needs.

How much time are you spending on interruptions?

Based on this Enlitic report, it could be quite a lot, and data governance can eliminate many of them.

The Wire

• CHNOLA Adds Cleveland Clinic Rads: Children’s Hospital New Orleans announced an interesting new partnership with Cleveland Clinic, allowing CHNOLA to supplement its radiology team with 16 Cleveland Clinic pediatric rads (general, neuro, cardiac). The alliance goes well beyond most telerad deals, as Cleveland Clinic will develop exam protocols, provide consultations, and expand CHNOLA’s overall cardiac MRI capabilities. It also appears to be part of an emerging system-to-system telerad trend, following a similar alliance between Allegheny Health and Penn State Health.

• UltraSight’s CE Mark: UltraSight announced the European CE Mark approval of its ultrasound AI guidance software, which allows novice clinicians to capture sonographer-level cardiac ultrasound images. This is UltraSight’s first major regulatory clearance, representing a significant milestone for the company and its flagship product. It’s also a sign that echo AI guidance could soon be gaining momentum in Europe, noting that Caption Health’s AI guidance solution gained its CE Mark last month.

• HCC Recurrence ML: A new AJR study suggests that MRI-based machine learning could be used to predict liver cancer recurrence and improve transplant decision making. The researchers used three ML models to predict recurrence among 120 patients with early-stage hepatocellular carcinoma (HCC; all transplant-eligible; 36.7% had recurrence). The study’s combined ML model (clinical data + MRI), MRI-only model, and clinical data-only ML model showed enough promise (AUCs: 0.76, 0.76, 0.68) to suggest that future HCC ML approaches could improve the criteria used to determine liver transplant eligibility.

• RI Medical Imaging Acquires XRA: Radiology practice and imaging center company Rhode Island Medical Imaging (RIMI; 12 locations, ~95 rads) further expanded across its namesake state, completing its acquisition of XRA (6 locations, ~10 rads). RIMI is Rhode Island’s largest private imaging company, helped by at least three acquisitions since 2015 (also: The Imaging Institute and Radiology Associates). 

• PET’s COVID Heart Insights: A team of Houston Methodist researchers used PET imaging to reveal that prior COVID infection may lead to reduced myocardial flow reserve (MFR) among patients with cardiovascular risk factors. When the researchers compared PET scans from 101 patients previously diagnosed with COVID to 292 control patients (median duration from diagnosis to imaging: 191 days), they found a 20% decrease in the ability of coronary arteries to dilate. They also found that patients with prior infection were twice as likely to have reduced MFR (58% vs. 28%), which the authors state “is a marker for poor prognosis.”

• Agora’s Seed Funding: Swiss image storage and sharing startup Agora Care scored CHF 1.8M in Seed funding ($1.86M) that it will use to expand its platform across Switzerland. Although the North American image sharing market is already dominated by a mix of major informatics players and well-funded startups (Ambra/Intelerad, PocketHealth, Novarad, Nuance, etc.), recent Seed rounds from Agora Care and Australia’s Aurabox suggest that demand for image sharing is driving the emergence of early-stage startups in other global markets.

• Trauma ED CT Overuse: A new AJR study highlighted massive CT volume increases from trauma-related emergency department visits. Analysis of 8.4M ED visits between 2011 and 2018 revealed that CT use per 100 trauma ED encounters more than doubled across a variety of exams, including chest CT (4.9 to 13.5), abdominopelvic CT (7.5 to 16.4), and single-encounter thoracoabdominopelvic CT (3.4 to 8.9). The authors called for more research evaluating the benefit of these exams, specially for patients with minor injuries.

• Health Plan Challenges: HealthEdge’s Voice of the Market Survey of 300 health plan execs found that commercial payors’ top two challenges are now managing costs (46%) and driving operational efficiencies (41%), a dramatic jump from their fourth and fifth positions last year. Although inflation typically impacts healthcare costs later than other sectors due to the multi-year nature of payor-provider contracts, the survey indicates that more health plans are beginning to target this issue by making significant investments in innovation (53%) and improving their engagement strategies (52%).

• Radiology Practice Leader Burnout: A new study in Clinical Imaging found that 33% of private radiology practice leaders (n=40) report feeling burned out, citing difficulty managing stress as the most common burnout driver. However, 43% of the respondents were professionally fulfilled, which the authors suggest demonstrates an inverse correlation between professional fulfillment and burnout (r = −0.42, p = 0.007). 

• Carestream Files for Ch. 11: Carestream Health filed for Chapter 11 bankruptcy last week, marking a key step in its recent recapitalization agreement, which was created to cut Carestream’s debt and make its top lenders into its new primary owners. Carestream now expects the recapitalization to eliminate $470M in company debt ($250M more than it first announced).

• Alpha Tau & MIM Software: MIM Software and Alpha Tau Medical expanded their radiation therapy partnership, leading to new product and commercial collaborations. The companies will co-develop new MIM-based software features intended for Alpha Tau’s Alpha DaRT RT systems, bundle MIM’s RT software with the Alpha DaRT in regions where both products are commercially available, and use MIM’s software in all Alpha DaRT clinical trials. MIM’s radiation therapy software suite uses imaging (CT, MRI, ultrasound) to guide clinicians through radiation therapy planning and targeting processes.

Automating Hyperfine Interpretations

Hyperfine’s MRI accessibility advantage doesn’t stop at image acquisition. See how Hyperfine’s BrainInsight AI tools give clinicians the quantitative biomarker information needed to streamline patient care and reduce the burden of manual brain MRI measurements.

Annalise CXR In Action

annalise.ai’s Annalise CXR solution detects up to 124 findings in a single chest X-ray. See how it detects such a wide range of abnormalities using these demo studies…  or upload your own CXR images.

The Resource Wire

• Siemens Healthineers’ AI-powered MR image reconstruction technology, Deep Resolve, allows faster scans without compromising imaging resolution. Check out how Deep Resolve improves workflow efficiency and the patient experience, and view their portfolio of reconstructed scans here.

• Working out your AI business case? Check out this helpful Blackford Analysis post outlining the three steps to help you justify AI adoption. 

• See how Valley Radiology’s decision to make Intelerad IntelePACS its single reading environment helped the independent practice gain control of its growing volumes and rising case complexity, improve its efficiency and radiologist experience, and deliver better patient care.

• See how 2-meter total body PET gives molecular imaging teams a diagnostic advantage compared to other “eyes to thighs” PET options in this editorial by United Imaging CEO Jeffrey M. Bundy.

• Learn how Windsong Radiology Group used Bayer’s MEDRAD Stellant FLEX CT injection system to drive efficiencies and standardization across its imaging centers.

• See how Ochsner Health overcame its CT imaging challenges by leveraging University of Wisconsin’s CT imaging protocols across its fleet of GE Healthcare scanners.

• Check out this Imaging Wire Show interview with Riverain Technology’s Chief Science Officer, Jason Knapp, where we discuss the evolution of imaging AI, how to get generalizability right, AI’s path forward, and much more.

• Check out this patient case study showing how the Arterys Chest I MSK AI allowed radiologists at CSE in Paris to identify a fracture that was missed in three previous interpretations.

• 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.

• Check out this Imaging Wire Show featuring Us2.ai’s co-founders, James Hare and Carolyn Lam MBBS, PhD, detailing Us2.ai’s unique origins, impressive capabilities, and big goals to automate echocardiography reporting across the world.

• After setting ambitious regulatory and commercialization goals, Lunit leveraged CARPL.ai’s platform and operational guidance to complete the clinical trials needed for its INSIGHT CXR and MMG AI tools’ FDA clearances.

• See how Novarad’s new VisAR augmented reality surgical navigation system enables physicians to find and reach their target destination more quickly – without the expense, footprint, and setup time of conventional navigation systems and robots.