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The Imaging Wire Show – Imaging IT and Radiology Efficiency

What kind of pressures are radiologists seeing, and how can imaging IT help? We talked to Peter Shen of Siemens Healthineers in this Imaging Wire Show.

Imaging IT

Software Closes Radiology Reporting Loop

In the never-ending quest to get referring physicians to follow radiologist recommendations for follow-up imaging, Massachusetts researchers in JAMA Network Open offer an IT-based solution: Structured reporting software that was found to triple the number of radiology reports judged to be complete. 

A recent study found that 65% of radiologist recommendations for follow-up imaging aren’t followed by referring physicians. Authors of that study found that recommendations that were strongly worded and communicated directly to referring doctors had higher uptake. 

But what if radiologists don’t follow this advice? In the new paper, researchers from Brigham and Women’s Hospital and Harvard Medical School offer a more structured solution thanks to software developed as part of their Addressing Radiologist Recommendations Collaboratively project. 

The ARCC software is a closed-loop communication system that’s designed to channel radiologist recommendations into a structured format that’s clearly understood, while also tracking whether they were accepted and fulfilled. The ARCC tool runs separately from the radiologist’s dictation software, so while it asks them to include a standardized recommendation sequence in their report, it leaves the specific free-text language up to them. 

Under the ARCC criteria, the main factors that make up a complete follow-up recommendation are:

• Reason for imaging study
• Timeframe when study should be completed
• Imaging modality to be used

The researchers implemented the ARCC software in October 2019 in thoracic imaging, and rolled it out to other departments through December 2020. Use of the software was “strongly encouraged but voluntary.” 

In testing the ARCC software’s effectiveness, the researchers found that the number of follow-up recommendations considered to be complete – with all three key elements – rose from 14% to 46%. Even so, one-third of reports filed with ARCC “still contained ambiguous language” in the free-text section – indicating that old habits are hard to break.

The Takeaway

Radiologists may hate it when their recommendations for follow-up imaging are ignored, but referring physicians are also frustrated with free-text radiology reports that are wishy-washy and contain vague impressions. The ARCC software could bridge the gap by steering radiologists toward recommendations that are more concrete and specific – and more likely to be followed.

Automating Echo AI

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.

AI’s Healthcare System Value

AI delivers value to a wide range of healthcare stakeholders, but its primary value to health systems originates from its ability to automate tasks, democratize care, and deliver hard and soft ROI. See how these factors impact health systems’ bottom line in this Arterys report.

The Wire

• Threat to Cancer Screening: A Texas judge’s ruling in a lawsuit against the Affordable Care Act could jeopardize federal funding for free screening exams. The judge ruled that the ACA can’t require group health plans and insurers to pay for preventive health services like cancer screening recommended by the USPSTF while also prohibiting out-of-pocket payments. Healthcare law firm Reed Smith said the decision could be “catastrophic” to cancer detection efforts – expect it to be appealed to a higher court. 

• Lung Screening Still Lags: If payments were cut off for CT lung cancer screening, would eligible smokers even notice? Researchers in JACR reported that only 1.8% of eligible Americans with commercial insurance got screened in 2017; rates were slightly higher for Medicare recipients (3.4%) but not by much. Adherence to CT lung screening has been disappointing since Medicare payments began in 2015  – reasons could range from fatalism among smokers to requirements for “shared decision making” between patients and providers.

• Pullback on Prior Auth: Insurance giant UnitedHealthcare plans to reduce the number of procedures requiring prior authorization by 20%, starting this summer. The company said that while prior authorization can “ensure member safety” and lower medical costs, it is a “pain point” for providers. Indeed, a recent AMA study found that prior authorization was leading to delays in care. United will also start a “gold card” program that will eliminate prior auth requirements for some providers.

• Online Learning Boosts Test Scores: Radiology residents who used an online learning platform turned in higher scores on a test of radiology knowledge. Researchers in BMC Medical Education analyzed the impact of two online educational platforms (Elsevier’s RADPrimer and STATdx) on the test scores of residents, finding that those who used the platforms most often had the highest test scores. The findings validate online medical education tools, which saw a spike in usage during the COVID-19 pandemic. 

• Enlitic Updates Curie Platform: Enlitic launched version 1.3 of its Enlitic Curie AI hosting platform. Curie is designed as the foundation for the company’s Curie | ENDEX and Curie | ENCOG applications, and will be expanded in the future to third-party AI algorithms. Curie | ENDEX uses NLP and computer vision create a standard naming convention for similar imaging studies, while Curie | ENCOG enables users to black out, alter, or delete PHI from images, enhancing data monetization strategies. 

• FDA Proposes Update to AI Rules: The FDA is proposing new rules that would update how it regulates changes to AI and machine learning software. Noting that the agency has authorized over 500 AI/ML devices, the FDA said its proposed guidance covers how such devices can be modified, updated, and improved in response to new data. FDA issued the proposal on the same day that a public letter went viral urging more stringent oversight of AI. 

• Deepc Raises €12M: German AI platform developer deepc has raised €12M in a Series A funding round. The company will use the proceeds to commercialize its deepcOS AI operating system, designed to serve as a platform for third-party AI applications for radiology. 2023 has been tough for AI startups looking for their next round, and deepc’s Series A is a welcome sign that VCs are still willing to invest in certain startups.

• Heart Shape Risks: Cedars-Sinai researchers found that patients who develop round-shaped hearts might have greater cardiovascular risks. The researchers used AI to analyze 38,897 subjects’ cardiac MRI exams, finding that independent of other clinical factors, one standard deviation increase in their left ventricular sphericity index was associated with greater incidence of cardiomyopathy (+47%), atrial fibrillation (+20%), and heart failure (+9%). They also found that LV sphericity is influenced by certain genetic attributes that are also associated with cardiomyopathy and atrial fibrillation.

• Calif. Center Closes Doors: Beset by lower reimbursement and rising costs, a California imaging center has decided to close its doors and send its patients elsewhere. The owners of Open System Imaging of Chico said the 24-year-old company was squeezed between lower imaging payments, higher labor costs, and growing expenses for advanced imaging equipment and maintenance. It’s a story that unfortunately could be told by many independent imaging centers and illustrates the forces hammering healthcare providers.

• Out-of-Pocket Costs Depress Follow-Ups: When patients have to pay for follow-up procedures out of their own pocket, they are less likely to pursue such exams. So says a study in JAMA Network Open that associated costs like co-payments and deductibles with lower adherence rates for diagnostic tests after suspicious breast screening exams. The findings are particularly disturbing given a Texas court ruling last week that could make it easier for insurance companies to charge patients for screening exams.

• Viz.ai Launches Trauma Suite: AI developer Viz.ai is expanding its product line into trauma imaging. The company launched Viz Trauma Suite, designed to help trauma providers reduce response times and comply with new standards for trauma centers. The platform includes a high-fidelity mobile viewer and communication features, and supports a wide range of modalities. After starting off with a neuro focus, Viz.ai has embraced a suite-based strategy to expand across other key service lines, including its new Radiology Suite and Cardio Suite, which launched within the last six months.

Solutions to Solve Radiology’s Workflow Challenges

Radiology faces numerous challenges to more efficient workflow, from the siloed nature of healthcare enterprises to mundane tasks that are ripe for automation. In this Imaging Wire Show, we talked to Dr. Matthew Lungren and Calum Cunningham of Nuance Communications.

The Essence of Visage

What impact is Visage 7 Enterprise Imaging Platform having on healthcare enterprises? Find out from Visage customers in their own words how Visage 7 can help you eliminate your legacy PACS.

Building a Successful Radiology Team in a Hyper-Competitive Market

In today’s hyper-competitive job market, radiologist recruiting and retention is more important than ever. Learn from industry experts and practice leaders in this on-demand Medality webinar as they reveal how to overcome hiring challenges, keep your team engaged, and provide opportunities for growth.

The Resource Wire

• An NIH paper detailing how portable MRI can aid in stroke assessments and democratize imaging access sparked this spirited conversation with Hyperfine’s leadership, providing two insiders’ perspectives on how portable MRI can achieve these improvements – and more.

• Now available on-demand: Learn how to optimize your CT workflow from scan to reconstruction in this webinar recording. Find out how NYU Langone Health leverages technologies from Siemens Healthineers to streamline their workflow and improve patient care. 

• Crouse Hospital is a nationally recognized cardiac care center in the Syracuse, NY, area, but the hospital’s cardiovascular service relied on separate data islands. That is, until Crouse Hospital adopted the HealthView CVIS from Intelerad’s Lumedx business. 

• Deciding between public and private cloud? Watch this brief Change Healthcare animation detailing the operational benefits of public cloud hosting for imaging.

• 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.

• Check out this Imaging Wire Show interview with Blackford Analysis founder and CEO Ben Panter, detailing how to solve AI’s assessment and deployment problem, AI’s downstream value, and what it will take for AI to have its greatest impact.

• What tools are available to help radiologists work remotely? In this case study, teleradiology provider 4ways Healthcare of the UK describes how they used Merative’s Merge PACS 8.0 platform to improve their service to clients while supporting remote radiologists.

• 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.

• See how Thomas Jefferson University relied on CARPL.ai to accelerate its AI validation and clinical adoption in this presentation by informatics and AI leader Dr. Paras Lakhani.

• This Bayer case study details how radiation benchmarking programs can help push CT dose exposure reduction initiatives from achieving compliance to driving quality.

• See what UC Davis has to say about United Imaging’s EXPLORER Total Body Scanner, the first whole-body PET.

• When one of Precision Imaging Centers’ 3T MRIs wasn’t meeting their requirements, they implemented Subtle Medical’s SubtleMR solution, rather than purchasing a new scanner or an expensive upgrade. See how SubtleMR enhanced Precision’s patient throughput and comfort, without compromising image quality in this case study.

• New digital detector technology is making possible a new realm of quantitative SPECT/CT. In this white paper from GE HealthCare, learn how to make SPECT/CT achievable in routine clinical practice while enabling precision healthcare and more personalized medicine.

• We may be entering a third wave of imaging AI’s rapid evolution, bringing a shift from narrow point solutions to comprehensive multi-finding AI systems. Hear this discussion with Annalise.ai Chief Medical Officer Rick Abramson, MD, exploring how this transition could take place, how radiologist and VC perspectives on AI are changing, and how AI might continue to evolve in the future.