Innovating Technology to Drive Collaborative Care

Dr. Richard Duszak, MD, FACR, Vice Chair of Health Policy and Practice, Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Dr. Randall Stenoien, MD, CEO of Houston Medical Imaging, Founder of Innovative Radiology comment on how fragmented the healthcare delivery system is,  how collaborative care can combat this fragmentation and lead to better efficiency, and the need for radiologists to be an integral part of patient portals as more patients use and rely on them.

What to Expect from the CARESTREAM Touch Ultrasound System

It has been almost two months since we announced the CARESTREAM Touch Ultrasound System (currently 510(k) pending) at RSNA 2014, and the excitement around the product has not dissipated.

Produced by Imaging Technology News (ITN), the video below includes Helen Titus, worldwide marketing manager for X-ray solutions and ultrasound, and Andrew Hartmann, general manager for X-ray solutions and ultrasound, discussing the all-touch control panel on the new ultrasound system, and what sets the technology apart from others in the field.

Titus and Hartmann also discuss how the Touch System is the premium version in what will become a portfolio of ultrasound technologies. The key being that once you know how to use one system, you can use the others in the portfolio.

Diagnostic Reading #6: Five Must-Read Articles from the Past Week

Crystal Ball

We begin to look at key trends to expect in 2015 as 2014 nears its end.

It’s been a week since RSNA has finished, but the conversations surrounding the show, the technologies, and the trends have not ended. In this weeks post, we look at AuntMinnie’s top trends from RSNA, along with predictions about what we can expect in the healthcare IT world in 2015. Other articles will look at how radiology reporting is evolving, how patients want more out of their EHRs, and how radiologists and referring physicians work best when they work together.

1) Top 5 trends from RSNA 2014 in Chicago

The key trends include RSNA celebrating its centennial, the popularity of sessions focused on CT lung screening now that the U.S. Centers for Medicare and Medicaid Services will reimburse for scans in high-risk smokers, enterprise focus driving imaging informatics, digital breast tomosynthesis and dense breast tissue dominating the breast imaging topic, and radiology recognizing the need for change.

2) Big Data Underpins Five Health IT Predictions for 2015

2015 trends to pay attention to include physicians beginning to embrace rather than abhor EMRs, a rise in the democratization of health information, pharma taking more of a care provider or services role in healthcare, a massive data breach forcing real action around health data privacy, and quality rising as the future king of the industry.

3) Reinventing Radiology Reporting: Adding Value by Leveraging Emerging Technology

While this also ran here, we want to share the Harvey L. Neiman Health Policy Institute’s publishing of the post. Richard Duszak, MD, is Chief Medical Officer, Harvey L. Neiman Health Policy Institute, and Vice Chair for Health Policy and Practice, Department of Radiology and Imaging Sciences, Emory University School of Medicine, shares the results of a RSNA digital poster focused on how multimedia enhanced radiology reporting can increase the value of radiology.

4) Patients Want More from Their EHRs

More patients are looking for enhanced features and functionality with their EHRs. The article focuses on the results of the study, “Engaging Patients and Families: How Consumers Value and Use Health IT,” which is a follow-up to a similar 2011 report that assessed consumer views toward EHRs.

5) Radiologists, Referring Physicians Work Better Together

As reported in the article, radiologists are more often inserting clinical expertise, even if it puts referring physicians on the defensive. The article shares the opinions of physicians and how they are accepting of the information radiologists provide. Technology is having an increasing influence on this relationship, resulting in referring physicians seeking input from radiologists.

Reinventing Radiology Reporting: Adding Value by Leveraging Emerging Technology

This post was also published on the Harvey L. Neiman Health Policy Institute’s website.

Over the last decade, the way we consume information has changed radically. Sure, reading the Sunday newspaper by the fireplace on a cold winter morning remains a rare treat. But curated content through Twitter or pushed content to my inbox that links me to constantly updated media outlet websites is now my main channel for information. Those sites are increasingly interactive, and like many readers I frequently view hyperlinked images, figures and charts to supplement my reading experience.

So why hasn’t radiology kept up with the times? For decades, radiology reporting has remained pretty much the same: free-form findings and text in a report. I believe referring physicians want more. A radiologist’s most valuable product is not laser toner on paper—it’s meaningful and actionable information. And the way we choose to consume our news should provide guidance on how to deliver diagnostic findings.

What if we could embed interactive hyperlinks to critical images—as well as quantitative analysis in the form of tables for vessel analysis or lesion management—into our reports? Referring physicians could navigate to these bookmarks in seconds directly from our reports, and so could our patients.

Technological enablers now exist to permit radiologists to offer this higher level of reporting. With this technology now coming to market, I was part of a team that compared referring physician satisfaction with multi-media enhanced reporting (MMER) to standard reporting. In an electronic poster entitled: “Traditional Text-Only vs. Multimedia Enhanced Radiology Reporting (MERR): Referring Physicians’ Perceptions of Value,” colleagues from Emory University, Carestream Health, and I presented our results from a survey of 200 U.S. medical oncologists, radiation oncologists, neurosurgeons and pulmonologists last week at RSNA.

About 80% of respondents said multi-media enhanced reports “improved understanding of radiology findings by correlating images to text reports” and delivered “easier access to images while monitoring progression of a disease/condition.” That was no surprise.

The real wow for me, though, was that just as many physicians indicated that such enhanced reporting would “increase the likelihood of referring patients to facilities that offer multi-media reporting.” That’s a pretty powerful message to radiologists and radiology administrators: give your customers what they want or they’ll take their business elsewhere.

The decision to deliver meaningful and actionable information—or not—will likely have a profound effect on imaging referral habits as this reporting technology enters the marketplace. Early adopters are likely to gain a referral advantage and secondary adopters will then be relegated to playing catch up for years to come.

While we should all be striving to add value to our work for value’s sake—just because it benefits our patients—the marketplace in which we practice is not so altruistic. Winning hospitals and practices will be the ones that provide stakeholders what they want. Based on our survey, referring physicians want more than just old-fashioned, text-based reporting.

The only way to fight off commoditization is by providing value. Delivering meaningful and actionable information is a powerful way to do just that.

Dr. Rich DuszakRichard Duszak, MD, is Chief Medical Officer, Harvey L. Neiman Health Policy Institute, and Vice Chair for Health Policy and Practice, Department of Radiology and Imaging Sciences, Emory University School of Medicine. The scientific paper documenting this research was presented at the RSNA conference from 12:15-12:45 pm on Wednesday, Dec. 3.

University College Hospital & Diagnostic Imaging Needs of Nigeria

We spoke with Dr. Biodun Adeyinka, consultant radiologist at University College Hospital in Ibadan, Nigeria at RSNA 2014 about what brought him and his colleagues to the meeting. He explained that while Nigeria is a wealthy country, he and his colleagues need to make a strong case for purchasing equipment. They came to RSNA to learn about the latest and greatest pieces of equipment and plan to bring this information back home to help with purchasing decisions.

Diagnostic Reading #5: Five Must-Read Articles from the Past Week

Carestream Booth at RSNA 2014

Carestream booth at RSNA 2014 in Chicago.

This week’s Diagnostic Readings include findings that were presented at the RSNA conference over the past week. Ultrasound training, radiation safety and health technology are some topics that were prevalent at RSNA.

1) Radiologists Must Play Central Role in Point-of-Care Ultrasound Training

With the adoption of ultrasound technology across the radiology industry, it is becoming a necessity to train medical professionals. David Bahner, MD, and Brian D. Coley, MD, discuss how radiologists need to step up and ensure that patients are getting proper care. Additionally, the presenters express the need to provide better ultrasound training in medical schools.

2) Radiologists Across the World Need to Lead the Way in Radiation Safety

With few new technologies in the radiology field, imaging safety has become a point of emphasis. Radiologists from across the world met at RSNA to talk about ways to make radiology a safer field. Dose reduction, education and appropriate use are a few of the topics that are addressed.

3) Integrating Radiology, Pathology Would Improve Diagnostics, Aid Patients

Developing channels for radiologists and pathologists to exchange patient information could lead to better patient care. Professionals from both fields have begun to discuss the most efficient ways to exchange templates. Radiology has been moving towards implementing standardized templates that mirror those of pathologists.

4) Many Chest Radiographs in Children Unnecessary

A study presented by Mayo Clinic at RSNA found that 88% of chest x-rays performed on children did not alter patient care. Reducing the amount of unnecessary x-rays could also reduce dose and cost.

5) Patients Like Accessing Imaging Records

According to a study presented by Mount Sinai School of Medicine, 96% of patients responded positively to receiving their images through a web-based interoperable system. This shows the benefit that comes from having available patient portals and enhancing patient engagement in medical care.

Text-Only vs. Multimedia Enhanced Radiology Reporting (MERR)

RSNA 2014 logoThroughout RSNA 2014, we have seen that the world of radiology is evolving. Beyond practices and legislation, technologies are expanding the way in which we collect, analyze, and share data.

In a poster presented today, Dr. Gelareh Sadigh shared the results of the study, “Traditional Text vs. Image and Interactive Data Embedded Multi-Media Enhanced Radiology Reporting: Referring Physicians’ Perceptions about Value.”

In addition to capturing radiologists’ reactions to using the multimedia reports, Dr. Sadigh, Dr. Rich Duszak, and the team at Emory University also looked at referring physicians’ perceptions about value in radiology received within the reports.

When exploring referring physicians satisfaction, the study looked at the opinions of medical oncologists, radiology oncologists, pulmonologists, and neurosurgeons in the United States. All of those participating in the study had more than two years of experience in the field and were referring more than 10 patients per week. The end results yielded 200 survey responses, with 46 years being mean age, and the gender demographic being 85% male. In regards to receiving paper versus electronic reports, a majority were receiving their reports electronically, with another majority receiving their reports as text only versus reports with both text and images.

The results of the study, which used Carestream’s Vue Reporting to create the multimedia reports, found that 80% reported an increase in referral probability when including text and images. Also, while 80% were satisfied with the current format of radiology reports, satisfaction was significantly higher in reports with combined text and images vs. text only reports.

Compared to historically text-only reports, the multimedia ones included hyperlinks, graphs, viewing relevant comparisons images, data and key images. When using the multimedia reports,  the interpreted value included an improved understanding of findings by correlating images to text reports. The multimedia reports also provided easier access to images while monitoring progression of a condition,  and saved time trying to understand findings without supporting images.

Like all studies, this one was not without concerns. Out of all respondents, 28% responded having concerns. The most common ones were that the multimedia reports were too time intensive because of all of the information within them. In some facilities, clinic workflow does not allow itself to view reports with such a high volume of information.

But in the end, when it came down to enhancing value for radiology, 80% indicated an  increased likelihood of preferentially referring patients to facilities that offer MERR, 79% indicated an increased likelihood recommending peers use facilities offering MERR, and respondents also said they were much more likely to give the reports to patients to enhance education. Overall, respondants saw multimedia reports as being a big improvement over text-only versions because of the value of information and detail offered within.

PulvinoRich Pulvino is the digital media specialist for Carestream. He sat in on the digital poster, “Traditional Text vs. Image and Interactive Data Embedded Multi-Media Enhanced Radiology Reporting: Referring Physicians’ Perceptions about Value,” which took place on December 3 at RSNA 2014 in the Learning Center – Hall D from 12:15-12:45 PM.

Gwinnett Medical Center & the DRX-Revolution

Gwinnett Medical Center in Georgia shoots over 100 portable X-rays each day. With this volume, they not only needed one reliable mobile X-ray system, but multiple. Since the installation of the DRX-Revolutions in their facilities, the results have been positive.

Karen Kubik, Imaging Director at Gwinnett Medical Center shares their story.