Roxana Daneshjou MD/PhD, a Stanford University dermatologist.

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Imaging Policy & Legislation

Medical Malpractice Crisis

Is a new crisis looming in medical malpractice insurance? An AMA analysis finds that medical liability premiums are skyrocketing again – and radiologists may be among the physicians most affected due to their higher exposure to malpractice suits.

The proportion of medical liability premiums that increased year-to-year for OB/GYN, general surgery, and internal medicine doctors (radiologists weren’t surveyed) doubled from 2018 to 2019 (13.7% to 26.5%), and went up 30% year-to-year from 2020 to 2022. The last time rates rose this fast was during the medical liability crisis of the early 2000s, according to the AMA paper.

Insurers are raising premiums due to deteriorating underwriting results, lower loss reserve margins, and lower returns on investment, per the report. These trends are echoed in a new analysis of the medical malpractice segment by credit agency AM Best, which describes a “difficult environment” for medical liability insurers. The medical professional liability segment has seen eight straight years of underwriting losses.

Why should radiologists care? Well, radiologists are more likely to have experienced medical liability claims during their career than most other physicians. Another AMA survey of over 6k doctors found: 

• Radiologists were more likely to say they had been sued in their career than all physician types (40.2% vs. 32.1%)
• More radiologists have experienced a lawsuit in the past year than all physicians (4.2% vs. 2.0%)
• The only other medical specialists more likely to be sued than radiologists were surgeons (48.9%) and emergency medicine physicians (46.8%) 

The first AMA report closes by saying that a medical liability insurance “hard” market – a market characterized by rapid price increases – already exists in a number of states, and is “slowly spreading” across the rest of the US. 

Further, there is “striking” geographic variation in premiums. OB/GYNs in Los Angeles County, California see average manual premiums of $49,804 a year, while those in Miami-Dade County, Florida are staring at a $226,224 liability insurance bill.

The Takeaway 

The AMA said the growing medical malpractice crisis could have multiple ramifications. Physicians in states with difficult liability environments could relocate or even drop some clinical services that raise their risk. Will the worsening environment draw the attention of state and federal regulators? Only time will tell. 

Nuance’s PIN Helps Identifies Emphysema

Emphysema is often underdiagnosed, and this can make treatment more difficult. FirstHealth of the Carolinas was able to improve its diagnosis of emphysema and enhance its CT lung screening service with AI algorithms available through Nuance Precision Imaging Network (PIN).

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.

The Wire

• Look out, ChatGPT: Online search giant Google has introduced its newest large language model AI algorithm, PaLM 2. Google developed versions of PaLM 2 fine-tuned for specific domains; Med-PaLM 2 was designed to synthesize medical imaging data and “could help radiologists interpret images and communicate results,” says an article in Forbes. Med-PaLM 2 already performs at the “expert” level on questions like those on medical licensing exams. The launch could help Google regain momentum in LLMs lost to OpenAI’s ChatGPT.

• Radiology Deals with Disaster: Radiology plays an important role in the medical response to mass casualty events, say researchers in Current Problems in Diagnostic Radiology. A group from Rutgers analyzed the response of radiology departments to eight mass casualty events, from the Boston Marathon bombing to a mass shooting in Texas in 2009, detailing what went right and what went wrong. Their advice to radiology departments? Have a disaster management plan in place before a mass casualty event occurs. 

• Philips to Pay $62M in China Probe: Philips has agreed to pay $62M to settle charges that it violated the Foreign Corrupt Practices Act in selling medical diagnostic equipment in China. A news release from the SEC details the alleged practices that led to the settlement, such as using price discounts that created “excessive margins” that could fund improper payments to government employees. The SEC in 2019 announced it was probing Philips, Siemens, and GE for alleged bribery payments in China.

• CT Biomarkers Predict COVID Death: The COVID-19 public health emergency may be over, but COVID is still a threat. In European Radiology, Italian researchers described the quantitative chest CT imaging biomarkers that portend a poor patient prognosis. In 1,669 patients, they found that an algorithm that included measures of coronary artery calcium and prevalence of liver steatosis, myosteatosis, and osteoporosis had better accuracy for predicting death than clinical variables alone (AUC 0.815 vs. 0.800).

• Omicron Symptom Shift: In another paper on CT of COVID-19, this one in Academic Radiology, researchers used CT in a population of 162 patients to discover that the rate of COVID-19 pneumonia was much lower in those who died during the omicron wave versus the pandemic’s first wave (83% vs. 53%). The finding indicates the changing appearance of COVID with later virus waves, and shows that mortality during omicron was driven either by non-pulmonary effects or was unrelated to COVID.

• UPenn Tussles with Gadfly: UPenn has become embroiled in litigation with plaintiff’s attorney Tom Bosworth, who has criticized the health system’s radiology practices. The Philadelphia Inquirer reports that Bosworth posted TikTok videos charging UPenn’s radiology department with being understaffed and of using technologists “with no medical training” to “interpret” patient X-rays; UPenn has denied Bosworth’s accusations. UPenn researchers in 2020 published a controversial study on the role of radiology extenders in improving the workflow of radiologists.   

• Esaote Debuts Portable Cardiac US: Italian ultrasound vendor Esaote used last week’s EACVI 2023 meeting to debut MyLab Omega eXP, a portable ultrasound scanner with cardiac imaging tools and AI automation. The new scanner sports quantification features and a dedicated cardiovascular edition with workflows for automating echo measurements thanks to CAAS Qardia, software from Esaote’s Pie Medical Imaging unit. The AI-supported echo segment has been active of late, with Philips acquiring DiA Imaging Analysis and GE HealthCare buying Caption Health. 

• X-Ray CAD Speeds Diagnosis: Researchers from Barcelona used CAD to analyze X-rays, finding it could enable earlier detection of lung cancer. In a study in Scientific Reports, researchers applied their CNN-based algorithm to over 20k chest X-rays that were reviewed by clinicians but not radiologists; lung cancer was confirmed in 22.5% of pulmonary nodules that CAD marked as highly suspicious. Researchers said CAD could help non-radiologists identify lung cancer sooner and avoid misses that delay diagnosis.

• FAST Protocols Accelerate MRI: MRI scans performed with focused abbreviated survey techniques can help reduce scanning times and diagnose emergent conditions quickly, say Wisconsin researchers in RadioGraphics. The FAST protocols target a total imaging time of 10 minutes and room time of 15 minutes; they rely on faster sampling such as with echo-planar imaging and accelerated reconstruction protocols like parallel imaging. First used for stroke, researchers are applying FAST MRI to other brain and spine applications and even screening.

• Atlas Speaks at Florida College: Scott Atlas, MD, America’s most famous (or notorious) neuroradiologist, will be delivering the commencement address this week at New College of Florida. Atlas served in the Trump Administration as a COVID-19 advisor during 2020, and was a vocal opponent of lockdown measures. New College of Florida has been undergoing an ideological makeover engineered by Gov. Ron DeSantis; Atlas was chosen for his belief in “personal freedom and individual autonomy,” according to the school.

• Quinsite Raises $5.5M: Data analytics software developer Quinsite has raised $5.5M in a Series A financing that the company said would fuel its expansion in radiology and also help it push into other specialties like pathology, anesthesiology, and orthopedics. The company’s Comprehensive Healthcare Analytics Platform integrates data from clinical, financial, and operational systems to help radiology practices operate more efficiently.

The Building Blocks of MR Safety

How can your imaging facility create a foundation for MRI safety? Learn from MRI safety expert Tobias Gilk on the best practices for creating a safe environment in this podcast with Medality.

Automating Echo Strain Analysis

Check out our Cardiac Wire publication’s latest Q&A with Us2.ai president and co-founder, Yoran Hummel, discussing how his career as a sonographer led him to echo AI, and how Us2.ai’s upcoming automated strain analysis feature brings the company even closer to democratizing echo.

Arterys’ All-in-One Neuro Platform

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.

The Resource Wire

• 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.

• The cloud will play a foundational role for a variety of healthcare applications, but perhaps one of its biggest impacts will be in supporting patient-centered care. Explore how the cloud will prove critical for ensuring patient-centered care in this editorial by Intelerad’s Morris Panner.

• We may be entering a third wave of imaging AI’s rapid evolution, that brings 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.

• The right hanging protocol can dramatically reduce radiologist reporting time. But how can you get the best hanging protocols for your radiologists? Learn how it’s done – and find out how Curie|ENDEX can help – in this white paper from Enlitic. 

• In this Bayer Radiology video, East Texas Medical Center Radiology Director Bill Tobin details how they used Bayer’s MEDRAD Stellant Smart Injector and contrast dose management to reduce contrast volumes and repeat scans.

• 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.

• It says a lot when a solution works so well for a radiology department that they decide to perform a study to quantify its benefits. In this Imaging Wire Q&A, University Hospital of Zurich’s Thomas Frauenfelder discusses his experience and study on Riverain Technologies ClearRead CT.

• 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.

• “It has changed the face of neuroimaging.” That’s one of the takeaways from Christ Hospital’s experience becoming the first healthcare system in New Jersey to implement point-of-care MR imaging into neurocritical care. Learn about their implementation process and the impact of providing quick bedside MRIs in this Hyperfine webinar. 

• Imaging’s cloud evolution didn’t happen all at once. This Change Healthcare animation details the history of digital imaging architectures, and how cloud-native imaging improves stability and scalability, ease of management, patient data security, and operating costs.

• What’s the latest news from United Imaging Healthcare? Driven by a focus on R&D, United has increased its brand influence and market share worldwide. Get the details in the company’s first annual report since going public. 

• When Middlesex Health set out to adopt imaging AI, the Connecticut-based community hospital made the unique decision to start with non-interpretive AI solutions. See how that decision led them to Subtle Medical, and the impact it had with all of the hospital’s imaging stakeholders.

• Women and their physicians may want to rethink cardiac symptoms. Learn about the case of a healthy, active 45-year-old woman who had to convince her doctors she was having a heart attack – and how technologies from GE HealthCare can help. 

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