Quote by a radiologist in Wuhan, China, who saw some of the first cases in the COVID-19 pandemic.

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CT Scanners

How COVID Crashed CT Scanners in China

In the early days of the COVID-19 pandemic in China, hospitals were performing so many lung scans of infected patients that CT scanners were crashing. That’s according to an article based on an interview with a Wuhan radiologist that provides a chilling first-hand account of radiology’s role in what’s become the biggest public health crisis of the 21st century.

The interview was originally published in 2022 by the Chinese-language investigative website Caixin and was translated and published this month by U.S. Right to Know, a public health advocacy organization. 

In a sign of the information’s sensitivity, the original publication on Caixin’s website has been deleted, but U.S. Right to Know obtained the document from the US State Department under the Freedom of Information Act. 

Radiologists at a Wuhan hospital noticed how COVID cases began doubling every 3-4 days in early January 2020, the article states, with many patients showing signs of ground-glass opacities on CT lung scans – a telltale sign of COVID infection. But Chinese authorities suppressed news about the rapid spread of the virus, and by January 11 the official estimate was that there were only 41 COVID cases in the entire country.

In reality, COVID cases were growing rapidly. CT machines began crashing in the fourth week of January due to overheating, said the radiologist, who estimated the number of cases in Wuhan at 10,000 by January 21. Hospitals were forced to turn infected patients away, and many people were so sick they were unable to climb onto X-ray tables for exams. Other details included: 

• Chinese regulatory authorities denied that human-to-human transmission of the SARS CoV-2 virus was occurring even as healthcare workers began falling ill
• Many workers at Chinese hospitals were discouraged from wearing masks in the pandemic’s early days to maintain the charade that human-to-human contact was not possible – and many ended up contracting the virus
• Radiologists and other physicians lived in fear of retaliation if they spoke up about the virus’ rapid spread

The Takeaway

The article provides a stunning behind-the-scenes look at the early days of a pandemic that would go on to reshape the world in 2020. What’s more, it demonstrates the vital role of radiology as a front-line service that’s key to the early identification and treatment of disease – even in the face of bureaucratic barriers to delivering quality care.

Monitoring AI Solutions in Healthcare

Clinical applications for healthcare AI are rapidly expanding, but many barriers are still preventing widespread adoption. This Nuance post explores a critical set of questions: what happens after an AI model goes into production, and how to know if it continues to perform as expected?

A Perfect Balance of Utility and Nirvana

The One Viewer philosophy from Visage offers end users from across the enterprise the chance to get access to Visage 7’s powerful tools based on their clinical need, with the same #1 rated viewer for multiple workflows. Find out today how it works.

The Wire

• Calls to Reform Medicare Rate-Setting: CMS has proposed new lower rates for the 2024 Medicare Physician Fee Schedule (MPFS), and the cuts are prompting calls for reform in how Medicare rates are set. The proposed rule calls for a 3.36% downward adjustment in payment rates, continuing a trend that has seen a 26% decline since 2001. Physician groups and legislators say Medicare’s rate-setting system is “broken” due to requirements like budget neutrality, and are urging Congress to step in.

• The End of Appropriate Use Criteria? In a positive MPFS development, CMS is proposing a “pause” to its effort to require referring physicians to use appropriate use criteria (AUC) for ordering advanced diagnostic imaging like CT and MRI. AUC was supposed to go into effect in 2021 as part of an effort to reduce unnecessary imaging, but CMS has postponed the deadline several times. The most recent pause could spell the death knell for AUC, but don’t expect many radiologists to attend the funeral. 

• Unshackling Radiotracer Reimbursement: In addition to new MPFS rates, CMS released 2024 proposed rules for the outpatient payment system. Radiology-relevant changes include a proposal to unbundle radiopharmaceutical payments and pay for tracers separately, which could lead to higher payments for nuclear medicine exams. Also, CMS said it would extend rules enabling virtual supervision of radiology studies with contrast – originally implemented during the pandemic – for one more year, until the end of 2024. CMS may even make the rule permanent at some point.

• What Makes Imaging Patients Anxious: A new study in JACR sheds light on patient anxiety before and after imaging exams. Of 315 patients in Australia, those who were in poorer health were more anxious about their imaging exams (OR=2.48), and those more anxious before exams were also more anxious afterward (OR=4.84). Interestingly, researchers did not see a decline in anxiety prevalence before exams (50%) compared to afterward (51%). The findings suggest that patients would benefit from more emotional support.

• Private-Practice Medicine Plummets: The share of physicians in private practice continues to plummet, falling 13 percentage points in the last decade and nearly 30 points over the past three decades. That’s according to a new AMA report that found the share of doctors in private practice has fallen from 2012 to 2022 (60.1% to 46.7%); private-practice rates were close to 76% in the 1980s. Some 49.7% of radiologists are in private practice, lower than surgeons (63.3%) but higher than other specialties tracked by the AMA.

• The Cost of Private Equity: In (perhaps) related news, a new report found that the number of physician practices acquired by private equity has grown rapidly, from 75 deals in 2012 to 484 deals in 2021. And healthcare costs rise when a single PE firm has more than 30% market share in a metropolitan area. Radiology costs grew 8.2% in these areas, which was still lower than the three fastest-growing top specialties: gastroenterology (18.2%), OB/GYN (16.3%), and dermatology (13.3%). 

• Study Links CAC to Gut Microbes: In a new study in Circulation, researchers from Sweden found a link between coronary artery calcification (CAC) on CT scans and gut bacteria. As part of the SCAPIS study, they scanned almost 9k people aged 50-65 without known heart disease. CAC was found in 40.3%, and 64 species of gut bacteria were associated with CAC scores, with some species also associated with inflammation markers in the blood. The question is whether the bacteria play a role in atherosclerosis development.

• BraCoil Optimizes Breast MRI: A wearable radiofrequency (RF) coil called the BraCoil could optimize breast MRI exams by improving signal-to-noise ratio (SNR). In Investigative Radiology, researchers from Austria and France describe their work on a flexible RF coil vest for 3-tesla scans that enables women to be scanned in the supine position. They compared BraCoil’s panoramic breast MRI approach to two other conventional breast MRI coils in 12 healthy volunteers, finding that BraCoil had an average 70% improvement in SNR across all breast sizes, and 3X better SNR in the smallest breasts.

• MRI Reveals Super-Ager Secrets: MRI scans have revealed differences in brain structure of super-agers – people who reach late life with cognitive function equivalent to individuals 30 years younger. In a study in The Lancet Healthy Longevity, Spanish researchers performed MRI scans on 64 people with a mean age of 81.9 years who were classified as super-agers. They had higher gray matter volume in several brain regions and slower total gray matter atrophy. The super-agers also did better on tests of motor skills, such as gait speed and finger tapping.

• AI Speeds Up Prior Authorization: AI is slashing the approval time for prior authorizations at Health Care Services Corp. (HCSC), from as long as 14 days to “nearly instantaneously.” HCSC developed an AI prior auth tool in 2021 and piloted it in specialty pharmacy and behavioral health in 2022. HCSC has expanded it to other areas, including outpatient services, and AI is used for 93% of HCSC members for some procedure codes. The news comes as some organizations raise concerns about the use of AI for prior authorization. 

• Komen Breast Cancer Registry: Breast cancer advocacy organization Susan G. Komen has launched a national cloud-based registry to accelerate breast cancer research. In the ShareForCures initiative, patients and survivors can share their personal data with Komen, and it will be made available to research partners and academic scientists approved by the group. Personally identifiable information will not be shared with researchers, Komen said. The project is designed to boost low rates of clinical trial participation (<10% of adult cancer patients).

• Infinitt Adds Us2.ai: Enterprise imaging vendor Infinitt North America announced a partnership with Us2.ai, and will add the echocardiography AI leader’s solutions to its Cardiology Suite. The alliance represents perhaps Infinitt’s first cardiology AI partnership (it has AI partnerships in other imaging domains), while continuing Us2.ai’s rapid AI marketplace and PACS platform expansion.

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 and keep your team engaged.

Creating a Heart Failure Screening Pathway for Novices

We hear a lot about echo AI’s potential to expand to far more users and clinical settings, and a study using Us2.ai’s AI-automated echo analysis and reporting solution showed that echo’s AI-driven expansion might go far beyond what many of us had in mind.

A Fast and Reliable Second Opinion

See why radiologist Dr. Eleanna Saloura called Arterys’ Lung AI solution “a fast and reliable second opinion” for chest CT lung nodule analysis and tracking, allowing “more accurate diagnostic and treatment decisions.”

The Resource Wire

• Adopting a platform strategy can simplify the deployment and management of imaging applications and AI algorithms, but there’s a lot to consider. In this eBook, Blackford Analysis and its clients detail how AI platforms can benefit clinical and IT teams, and share guidelines to consider when selecting a platform.

• SOIN Soluciones Integrales of Costa Rica turned to enterprise imaging solutions from Merge by Merative when it wanted to modernize the imaging environments of 50 hospitals across the country. Download this PDF white paper to find out how they did it.

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

• Groundbreaking innovations are taking place in diagnostic imaging and treatment for Alzheimer’s disease. But access to PET scans are crucial to truly take advantage of these advances, according to this article by Catherine Estrampes, president and CEO of US and Canada at GE HealthCare. 

• Did you know there are four main indicators that show informed patients have better clinical outcomes? Check out this analysis from PocketHealth on why empowered patients make better patients. 

• 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.

• What are the top 5 innovations in radiology? In this article, find out what the folks at Enlitic think are the trends transforming medical imaging and improving patient care. 

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

• When the VA adopts your technology nationwide, you know you’ve been making an impact. That’s exactly what’s happening with Riverain Technologies’ ClearRead CT, which will be implemented across the VA Lung Precision Oncology Program (22 hub and 87 spoke locations).
  
• Faced with the task of monitoring the thousands of exams its algorithms analyze each day, Qure.ai leveraged CARPL.ai’s validation workflow to create a real-time performance dashboard. See how they did it here.

• A new platform from Clearpath now enables healthcare providers to delight their patients by sharing images and medical records digitally. Find out how it integrates simply into your practice. 

• Clinical burnout is widespread in healthcare. What can be done to combat burnout in imaging? Listen to Sonia Gupta, MD, of Change Healthcare as she addresses the concerns and offers possible solutions that you can use right now.

• Subtle Medical has been named to CB Insights’ 2023 list of top 100 AI companies worldwide. The laureates were picked from a pool of nearly 9k companies, and were chosen based on a variety of criteria developed by CB Insights.

• Patient-centric care was one of the major highlights at HIMSS 2023. What role does medical imaging play in this patient care pathway? We talked to Morris Panner and A.J. Watson of Intelerad at the meeting.

• See how United Imaging’s uCT ATLAS combines advancements in image quality, patient comfort, and operator efficiency to bring you one step closer to your masterpiece.