AUGUST 2021 | VOLUME 5 | ISSUE 8
THEICECOMMUNITY.COM
ADVANCING MAGAZINE
IMAGING PROFESSIONALS
Where in the Hype Cycle is Radiology AI? PAGE 32
PRODUCT FOCUS
ARTIFICIAL INTELLIGENCE PAGE 29
In Focus
Nicole dhanraj PAGE 10
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FEATURES
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40 DIRECTOR’S CUT
EMOTIONAL INTELLIGENCE
AI can be great, but emotional intelligence will never be replaced by a computer.
It’s not uncommon for team leaders to function as supervisors, trainers, leaders, managers and even front-line workers.
32 COVER STORY
It is difficult to truly know if artificial intelligence can meet expectations. Insiders share their thoughts on the “hype cycle” of the technology.
16
OFF THE CLOCK
Kile Jackson has spent almost half a century in the medical imaging world and even more time has been dedicated to music, including the sometimes hectic Seattle music scene.
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ICEMAGAZINE | AUGUST 2021
ADVANCING THE IMAGING PROFESSIONAL
AUGUST 2021
19 PRODUCT FOCUS
The global health care AI market is expected to grow substantially in the near future.
12 WWW.THEICECOMMUNITY.COM
IMAGING NEWS
The latest medical imaging news from around North America.
29
RISING STAR
Susan ‘Sue’ MacIntyre is an MRI supervisor with a passion for safety and patient care.
ICEMAGAZINE
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MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090
CONTENTS SPOTLIGHT 10
Publisher
12
Vice President
14
Rad Idea MRI safety standards
16
Off the Clock Kile Jackson
John M. Krieg john@mdpublishing.com
Kristin Leavoy kristin@mdpublishing.com
Editorial
John Wallace Erin Register
Art Department Jonathan Riley Karlee Gower Taylor Powers
Account Executives Jayme McKelvey Megan Cabot
Events
Lisa Lisle
Rising Star Susan ‘Sue’ MacIntyre, MRI supervisor/MRSO at University of Pittsburgh Medical Center
NEWS 19
Imaging News A Look at What’s Changing in the Imaging Industry
26
ICE Webinars Capital Costs and Patient Care Improvements
PRODUCTS
Circulation
28
Market Report Trends Boost AI Growth
Digital Department
29
Product Focus Artificial Intelligence
Jennifer Godwin
Cindy Galindo Kennedy Krieg
Accounting
INSIGHTS
Diane Costea
Editorial Board
Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak
36
Imaging Diversified A Closer Look into Imaging Diversified Q&A
39
Coding/Billing Billing for Spot Images (or Not)
40
Director’s Cut AI Can’t Replace Emotional Intelligence
42
Emotional Intelligence Team Building 201: The Role of a Leader
45
PACS/IT AI: Seeing What’s Next
46
Roman Review The Add-Ons
48 49 51
AMSP Member Directory
ICE Magazine (Vol. 5, Issue #8) August 2021 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2021
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In Focus Nicole Dhanraj, Northern Arizona Healthcare Systems Director
ICEMAGAZINE | AUGUST 2021
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SPOTLIGHT
IN FOCUS NICOLE DHANRAJ
BY JOHN WALLACE
N
orthern Arizona Healthcare Systems Director Nicole Dhanraj, Ph.D., SHRM-SCP, GPHR, CPPS, PMP, CRA, R.T (R)(CT)(MR), excels at your job and in giving back to the imaging community. It says a lot about a woman who stumbled into what has turned out to be a very successful career.
Nicole Dhanraj enjoys her work and says she has benefited from an opportunity to work with some great people.
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Her career began in a way that introduced her to radiology. “Well, I really wanted to be a vet,” Dhanraj recalls when asked about how her career started. “However, circumstances led me to inquire what the military had to offer, and I guess I signed a contract and landed in radiology school!” She is pleased with how things turned out and looks forward to going to work every day. “Because I get to leave a legacy in radiology, leave radiology better than I found it,” Dhanraj said when asked why she loves her job. “I get to impact our com-
munities through imaging and, most of all, work with a team who want the best for our patients.” She said her approach to leadership is “vulnerable and authentic.” “I recognize that I know that I do not know, so I am not afraid to ask for help of others,” Dhanraj explained. “I bring my all to the team. I truly care about them. My style is a combination of servant and transformational. I try to inspire through example and create a safe space so staff can approach me with any situation. I also want to create a memorable experience of their director, so I try to focus on developing connections so people can trust and have confidence in me leading them.” On the other hand, Dhanraj said she has benefitted from the opportunity to work with some great individuals. “My mentors have pushed me beyond what I thought I was capable of. They have helped me build critical thinking skills, a strategic mindset and my emotional
ADVANCING THE IMAGING PROFESSIONAL
NICOLE DHANRAJ, Ph.D, SHRM-SCP, GPHR, CPPS, PMP, CRA, R.T (R)(CT)(MR)
Systems Director Northern Arizona Healthcare What is the last book you read? Or, what book are you reading currently? I am immersed in all sorts of health care related journals/magazines on topics such as nursing, finance and, of course, radiology! Favorite movie? Gosh, I have not watched a movie in a while, but enjoy all sorts of genres and from various cultures! But I sure do love anything with Jason Statham, Liam Neeson, and my favorite Indian star, Hrihtik Roshan. What is something most of your coworkers don’t know about you? I love anything international! Latin Dancing, Afrobeats, Reggae, Reggaeton, Soca, Hawaiian island music … the international list is long!
“My mentors have pushed me beyond what I thought I was capable of. They have helped me build critical thinking skills, a strategic mindset and my emotional intelligence.” intelligence,” she said. “My mentors, interestingly, are raw with me, and I think that is critical because they don’t always sugar coat their words. They tell me as it is, push my limits and help me to break my own perceived barriers. I have been broken down and put together so many times, but in a good way!” “I mentor the next generation of leaders through the MTMI pathways to leadership program, my manager, supervisor and the newer leads in my organization. I also have several people that I informally mentor, especially as challenges arise or they seek new opportunities,” she added. “I mentor health care dissertation students through Walden University.” Dhanraj adds that she enjoys learning about other industries and borrowing techiques, ideas, processes and more and using them at work. “I am like an octopus. I love to learn about various industries and learn new tools and techniques so I can apply to my current operation. I am proud of my diverse background as I think that has been the foundation to keep breaking my own ceiling of knowledge and expertise,” she said. Away from work, she enjoys spending time with her family that includes her husband, four children, two parrots, two parakeets and a fish. •
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Who is your mentor? I have several people that I reach out to based on their expertise or the situation that I face. But notable folks are Jai Salters, David Weir, Parsuram Ramkissoon, Jack McDaniels, Jessica Sawyer to name a few. What is one thing you do every morning to start your day? Express gratitude! It’s another day to save the world one X-ray at a time! Best advice you ever received? I can’t control everything. No matter how badly I may want to change a situation, or control the outcome, I do not always have that ability. Who has had the biggest influence on your life? My parents and my family. What would your superpower be? Cloning myself so I can help people in various areas all at the same time! What are your hobbies? Reading, exploring the outdoors, traveling. What is your perfect meal? Good ole homecooked Trini food.
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SPOTLIGHT
RISING
STAR SUSAN ‘SUE’ MACINTYRE
BY ERIN REGISTER
S
usan “Sue” MacIntyre, MRI supervisor/MRSO at University of Pittsburgh Medical Center, has been in the imaging field for 34 years. MacIntyre grew up in two small towns – Kittanning, Pennsylvania and Apollo, Pennsylvania. Up until her junior year of high school, she had plans to be a music major at IUP (Indiana University of Pennsylvania). After a change of heart, she graduated from Kiski Area High School in June of 1984 and started X-ray school for her associate degree in science and radiology at Penn State University and Shadyside Hospital. “After X-ray school, I got a job in Woodbridge, Virginia,” said MacIntyre. “I went there for about 12
ICEMAGAZINE | AUGUST 2021
8 months, then came back to an X-ray job in Jeannette, Pennsylvania. By the fall of 1989, I found an MRI job doing mobile all over western Pennsylvania. By July of 1991, I started working for UPMC in Pittsburgh for their new MRI center. I left UPMC briefly in 1996 for an MRI applications job working with MRI digital data and traveling to a variety of hospitals and outpatient centers. In 2001, I transferred from UPMC Presbyterian to UPMC Shadyside for both CT and MR. I always say that I ended up right back where I started, since I attended X-ray school here.” In 2002, MacIntyre became the lead MRI tech at Shadyside and by 2008 she was a supervisor. In 2014, MacIntyre decided to return to school for her bachelor’s in medical imaging and then moved on to a
Susan MacIntyre (back row, far right) enjoys working with her colleagues at UPMC Shadyside.
ADVANCING THE IMAGING PROFESSIONAL
SPOTLIGHT FUN FACTS Favorite Hobby:
I have seasonal Indy 500 tickets, because I’m a huge Indy car racing fan. I also enjoy doing some yard work with flowering and plants or just sitting outside enjoying the sun.
Favorite Vacation Spot: Disney World. My husband and I are members of the Disney Vacation Club, and we usually visit the area about twice a year.
Secret skill/talent: Well, since I spent most of my childhood planning for a music career, I play a variety of musical instruments.
to visit. favorite place d her husband’s an e Su is ld or Disney W
master’s in healthcare administration, which she finished in February 2019. In September of 2016, MacIntyre became certified as an Magnetic Resonance Safety Officer (MRSO) from the American Board of MRI Safety (ABMRS). In November of 2019, she passed the Certified Radiology Administrator (CRA) exam from AHRA. ICE learned more about this “Rising Star” in a recent interview.
A: I enjoy working with the staff and being a contact person for issues in patient care, workflow, general operations, etc. I also enjoy being the MRSO and taking care of MR safety items. I love MRI and learn something new almost daily. The field advances every day, so, it’s never boring.
Q: WHY DID YOU CHOOSE THIS FIELD?
A: I think the technology that currently exists and the technology coming in the future of imaging is quite exciting. I really enjoy all of the things we do for the patient experience. I think, overall, that imaging is a fascinating field where you can learn not only patient care, but about technology that helps in every aspect of medicine.
HEADLINE
A: In my junior year of high school, I really started thinking about my career because, in music, I was afraid that I would spend years in school to do musical therapy, and may not be successful in the end, nor able to make enough money to live independently. I started looking at the health field; a lot of my friends were going to be nurses, but I didn’t want that. A friend whose older sister was an X-ray technologist started telling me all about that, so I became interested. The next thing I knew, I was signed up for X-ray school.
Q: WHAT DO YOU LIKE THE MOST ABOUT YOUR POSITION? WWW.THEICECOMMUNITY.COM
Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD?
Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: For me, my greatest accomplishment has been my certification as an MRSO. I worked so hard over the years to gain as much knowledge and understanding in MRI as I could, and I was so very proud the day I passed that
exam. I only spent a small amount of my career as a radiologic technologist. My focus changed quickly to MRI when it started to develop as an imaging modality. At that point, my goal was to work in MRI and work for Dr. Emanual Kanal at UPMC. I accomplished the goal of working at UPMC in 1991, so it just continued when I got my MRSO certification in 2016.
Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: I have a few things I would like to do. I am a huge advocate for MR safety, so I’m trying to network and spread the word on the importance of safety in health care, such as speaking at ICE, writing articles for both the ASRT and AHRA, etc. I’m one of five moderators for the U.S. MR Safety group on Facebook, which has over 25,000 MR personnel from all over the world. We help each other learn and share work experiences. I also would love to advance in the imaging ladder and become an imaging director, so that I could grow in this field and expand my knowledge to all of radiology, which was really the goal I had in mind when I was obtaining my BA, MHA and CRA. • ICEMAGAZINE
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SPOTLIGHT
Rad idea By Sue MacIntyre, CRA, MHA, R.T(R)(MR), MRSO (MRSC)
T
his July marked the 20th anniversary of the death of Michael Colombini. Colombini was having an MRI when a nurse handed a ferromagnetic oxygen tank to the anesthesiologist that was tending to Colombini in the scan room. The tank became a projectile, hitting him in the head, and three days later, he died from blunt force trauma. It was estimated that the oxygen tank hit Colombini at a speed of 45 miles per hour. As a result of this MRI accident and others, the American College of Radiology created a blue-ribbon panel for MRI safety that year. In 2002, the panel published the first white paper on MR safety. The document was intended to be used as a template for MR facilities to follow in the development of an MR safety program.1 This publication was recently updated to the ACR Manual on MR Safety. Discussing safety recommendations for MR facilities, the document is of immense value to any imaging professional. MRI has continued to grow as one of the most accurate modalities in health care. Where are we now in MR safety? Unfortunately, not much has improved. There are few state or federal regulations. MRI accidents are on the rise, little has been done to put provisions in place for developing these recommendations into regulated standards. The ACR’s document contains measures for providing an MR safe environment. To date, no organization, including the ACR, has responded by requiring those safety provisions to be in place prior to receiving accreditation or compliance approval.4 The Joint Commission has published articles for their members about MRI accidents, but they have not selected a specific MRI criterion for on-site surveys.4 There are important safety needs unique to MRI: zoning restrictions, specialized non-ferrous equipment, appropriate staffing levels, ferromagnetic screening and hazard warning signs. All of these can help keep patients, visitors and staff safe while in the MR environment. The root cause analysis from the Michael Colombini case caused the MR industry to realign its safety measures. Over the past 20 years, most of the industry has valued the information learned from the
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Colombini accident, but we have a long way to go in placing standards and regulations in MRI safety practices. Help promote MRI Safety at your facility: • Appoint an MRMD MR Medical Director/Physician2 » MRSO (MR Safety Officer) and MRSE (MR Safety Expert) • MR technologists should comply with the technologist qualifications listed in the ACR MRI Accreditation Program requirements.3 • Develop MRI policies and procedures and update annually2 • Personnel needing to enter Zone III must first pass an MR safety screening process.2 • Follow ACR recommended staffing2 » (2) MR Personnel per unit (Level I and Level II)2 • Zone your MRI department into Four Safety Zones2 » Zone I: General Public { Free access » Zone II: Interphase between zones, patient triage/ gowning { Supervised by Level II (Technologist) » Zone III: Restricted/Controlled by Level II Personnel { Screened personnel only { Restricted » Zone IV: Magnet Room { Highly restricted References: 1. American College of Radiology. White Paper on MR Safety. 2013. Accessed June 3, 2021 2. American College of Radiology. Manual on MR Safety. 2020. Accessed June 3, 2021 3. American College of Radiology. ACR MRI and Breast MRI accreditation personnel requirements 2019. Accessed March 24, 2020. 4. Tobias Gilk and Robert J. Latino. MRI Safety 10 Years Later. 2011. Accessed June 11, 2021.
Share your RAD IDEA via an email to editor@mdpublishing.com.
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SPOTLIGHT
Off Clock THE
NEW ACCOUNTS AND TECH SUPPORT BY MATT SKOUFALOS
B
iomed and service technician Kile Jackson’s health care career has included long runs with companies from GE to Modern Medical Systems (now Crothall Healthcare Technology Solutions), and most recently, Summit Imaging of Woodinville, Washington, where he serves as a customer service engineer. But setting aside the nearly 50 years he’s spent in the medical field, Jackson has enjoyed an even longer career as a professional musician. Growing up on a small farm around Guthrie Center, Iowa, some 50 miles west of Des Moines, Jackson learned to turn a wrench on appliances just by hanging out with his dad, who worked as a Sears service manager. From fixing washers, dryers, and refrigerators, Jackson soon graduated to HVAC systems and televisions once his father’s colleagues realized he could handle himself at the tech bench. But long before then, it was a bout of childhood rheumatic fever that 16
ICEMAGAZINE | AUGUST 2021
first set his facile hands to work on a musical instrument. Confined to the family farm with the illness during his fourth-grade year, Jackson bought a Sears catalogue guitar with money sent from well-wishers. He learned to play by looking over his shoulder to see which chords Kenny Rogers or Paul Revere and the Raiders were picking out on television. By the time he got out of the hospital, his parents had decided to move into town proper, and his father continued Jackson’s musical education, driving the boy into Des Moines for weekly lessons at a local music store. Jackson went from playing in high school bands to booking his own shows at clubs in the city, and his father graduated from wheelman to doorman, collecting money at the shows. Five or six nights a week in the Des Moines music scene, Jackson’s band, Hip Pocket — their name taken from Tower of Power’s 1973 hit “What is Hip?” — opened for touring country acts who later hired the players to be their own backing bands. As the Des Moines music scene developed through the 1970s and 1980s, ADVANCING THE IMAGING PROFESSIONAL
Kile Jackson first picked up a musical instrument as a fourth-grader.
Hip Pocket played hotel circuits, the downtown arts district, and even began recording jingles and radio ads. Meanwhile, Jackson took a day job in insurance that eventually led him to a hospital setting, where he found a more fitting niche wrenching on medical equipment. When the droughts hit Iowa in the 1980s, he took a vacation to Seattle, and found a market where “there were jobs all over.” Not long after, Jackson moved to Washington for good, parlaying his experience as a hospital biomed into a gig with GE. The music scene there “was just flourishing,” he said, and Jackson was right in the thick of it, assembling a country band, The Rangers, that performed six and seven nights a week. “We would do a live broadcast from the dancehall at The Riverside Inn in Tukwila, Washington, and we were one of the house bands there for seven years,” Jackson said. “We were voted Seattle’s best country dance band in 2001 and 2003. We catered to all that urban cowboy stuff, and then took that into the casino shows.” When booking agents sought acts who could deliver 1950s music at large, seasonal car shows, Jackson formed The Edsels. When casinos were looking for Motown Top 40 acts, he formed The Hit Men; when wineries opened up to stripped-down performances, he formed a duo with his keyboardist and chief collaborator, Dave Cashin. In every incarnation, Jackson thrived because he was able to recruit and keep up with top-tier talent. Cashin had played with bluesman Keb’ Mo’ in his early days. The Rangers’ drummer, John Agostino, performed with country musician Vince Gill for years. Guitarist John Morton was the musical director for Seattle circus
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dinner theater Teatro ZinZanni. When Jackson was diagnosed with Stage Four throat cancer at 53, he met Danish harmonica player Lee Oskar, who’d toured and recorded with the funk fusion act War; they eventually collaborated on some studio recordings. Heavy metal guitarist Michael Wilton from Queensryche, and Alan White, the drummer from prog-rock pioneers Yes, have also joined Jackson in the studio. Those connections wouldn’t have been made without his commitment to the craft of being a working musician. “Music’s a love; it’s a passion,” Jackson said. “Life would be pretty boring without music. The camaraderie of mentally linking with a fellow musician – and it’s unspoken – there’s some of these players you play with, and the minute you’re onstage with, it’s magic. There’s nothing like igniting the soul when you’re playing with players who are just locked in.” As a bassist and vocalist, Jackson has lived a life of working days in hospitals and playing shows at night, so much so that he’s seen the Washington music scene transition from bar gigs to casino gigs to winery shows, as tastes (and smoking laws) evolved. But nothing had so dramatic an impact on his career as the novel coronavirus (COVID-19) pandemic shutdown. “Things just crashed immediately,” Jackson said. “I’ve lost well over 140 shows since COVID hit. We said, ‘I guess if we can’t play, we’ll
just do studio recording.’ ” That’s a far cry from the Seattle music scene of the 1990s, which Jackson can only describe as “insane,” as the modern country movement erupted alongside the mainstream following that emerged behind grunge rock. “There was one year we did 36 shows a month and never played a Monday,” Jackson said. “We were going from small town to small town on crazy schedules. Back then we were carrying pedal steel guitars and line dancers at the big shows.” Classic country is still his favorite musical genre to play, and Jackson has shared bills with some of its greats, including Willie Nelson, The Mavericks, Lonestar, Vince Gill, and the Gibson/ Miller Band. Despite that impressive resume, Jackson’s quick to point out that he enjoys “everything from Norah Jones to Michael Bublé.” “So many musicians get locked into one style of music and they never explore the other stuff,” he said. Amidst it all, Jackson raised two sons who are also talented performers – although growing up with a living room given over to musical instruments and amplifiers, they never had to send away for a Sears catalogue guitar. Both still live close by; both still play, he said. “It’s just been a musical family,” Jackson said. “We’ve all been smitten by music.” •
Kile Jackson has performed a wide variety of music over the years.
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Imaging A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY
News
ICE2022 IMAGING CONFERENCE & EXPO FEBRUARY 20-22, 2022 • NAPA, CA
ICE 2022 ANNOUNCES CALL FOR PRESENTERS The 2022 Imaging Conference and Expo will be held in Napa, California on February 20-22. The Imaging Conference and Expo (ICE) is the only conference dedicated to imaging directors, radiology administrators, and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. ICE offers valuable CE credits from the AHRA and ACI (pending approval) via its comprehensive educational opportunities for attendees. Whether it’s invaluable continuing education, productive networking or the exclusive exhibit hall, LOGO attendees will have the perfect opportunity to enhance their careers and spend time with colleagues. As an added incentive, ICE conference admission is complimentary for all hospital and imaging center employees, active members of the military and students. ICE continues to be the only conference to combine leaders in imaging management with imaging engineers, providing an exclusive and unique community of key decision makers and influential imaging professionals. ICE is the perfect resource to grow and prosper, personally and professionally. ICE 2022 is currently accepting submissions to present at the conference. Imaging experts and thought leaders are invited to submit a proposal to share their experiences and expertise with colleagues at ICE 2022 in Napa, California. For more information, visit AttendICE.com.
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PHILIPS, AKUMIN ANNOUNCE PARTNERSHIP Royal Philips and Akumin Inc., a leading provider of outpatient diagnostic imaging services in the U.S., have announced a strategic collaboration to deploy Philips’ new Radiology Operations Command Center across Akumin’s outpatient imaging centers and co-create clinical standards for Akumin’s MR and CT imaging modalities. Designed to centralize, virtualize and standardize network-wide imaging operations while facilitating secure remote access, Philips’ vendor-agnostic command center broadens the scope of collaboration and expertise sharing between technologists, radiologists and imaging operations teams across multiple sites – capabilities that fit perfectly into Akumin’s networked imaging center model. Akumin, which currently operates over 130 outpatient imaging centers across seven U.S. states, is Philips’ first large-scale commercial Radiology Operations Command Center customer in North America. “We are very excited to partner with Philips on this important strategic initiative to standardize the delivery of clinical care to our patients, while ensuring business continuity, improving ‘first time’ image quality, and increasing our clinical personnel productivity,” said Riadh Zine, president and CEO of Akumin. Leveraging the capabilities of the command center, Philips and Akumin aim to establish best-practice clinical standards for Akumin’s MRI and CT modalities to enable a consistent approach to imaging procedures across the Akumin platform. It will also allow Akumin to implement centralized tailored support for individual imaging centers to improve their on-site clinical expertise.
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NEWS
CRITICAL ACCESS HOSPITAL IMPROVES SCHEDULING PREDICTABILITY Lost Rivers Medical Center, a critical care access hospital in Arco, Idaho, has significantly reduced room cleaning and decontamination times, enabling staff to accurately schedule more patients in a day by implementing Surfacide’s automated UV-C decontamination technology. Originally purchased for use with its Aquilion Lightning CT system from Canon Medical, Lost Rivers is using the Surfacide Helios Systems in its CT and X-ray rooms with plans to expand to its surgical suite. “Surfacide has helped our infection control teams decontaminate rooms quickly, so room turnaround time is much faster and patients aren’t having to wait as long for rooms,” said Susan Collins, director of ancillary services, Lost Rivers Medical Center. “It’s so easy to use and transport throughout the hospital. As soon as we can properly train all of our maintenance personnel, we plan to use the tool more widely across the whole hospital.” To meet the need for fast disinfection, Canon Medical Systems USA Inc. has partnered with Surfacide to offer its Helios System — a rapid decontamination tool for its imaging equipment. The Surfacide Helios System consists of a trio of automated UV-C disinfection “robots” that
work together to significantly reduce bacteria, spores and virus on hard surfaces and are effective against a variety of multi-drug resistant organisms that could cause viral infectious diseases. Using multiple “robots” simultaneously emits more energy throughout a room in a single cycle, which helps shorten disinfection cycle time to just minutes and ultimately improves workflow. “Helping our customers deliver superior care to patients has always been at the forefront of our Made for Life philosophy,” said Erin Angel, managing director, CT business unit, Canon Medical Systems USA Inc. “Whether that’s providing innovative imaging and interventional systems or the tools needed to decontaminate those systems so they are safe for patients, we are committed to providing solutions our customers can use to improve their business and better serve patients.” In 2020, Lost Rivers Medical Center set out to upgrade its 16-slice CT system with one that could help them perform better lung imaging and enhance patient care. They selected Canon Medical’s Aquilion Lightning 80-slice CT system for its high image quality and dose reduction technologies.
HYPERFINE ANNOUNCES NEW PRESIDENT/CEO Hyperfine Inc., creators of the world’s first portable compact magnetic resonance imaging device, has named medical device industry veteran Dave Scott as its president and chief executive officer to support the company’s commercialization and growth strategy. Scott joins Hyperfine with a 25-year career building and leading high-performing teams at both startups and Fortune 500 companies related to digital surgery, digital health ecosystems, surgical robotics and medical imaging and diagnostics. He has a passion for disruptive innovations and has built and successfully scaled four startup companies to commercialization. As CEO, Scott will lead the company’s strategic growth plans for the rapid commercialization and adoption of the Swoop MR Imaging System.
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“Throughout his career, Dave has taken concepts previously considered improbable or even impossible – much like putting MRI on wheels – and made them real,” Dave Scott commented company founder Dr. Jonathan Rothberg. “I have no doubt that his visionary way of thinking and doing will help us achieve our giant vision for the future of Hyperfine.” “The possibility and potential that Hyperfine’s Swoop presents to truly change the landscape of healthcare for the world’s caregivers and their patients is an awe-inspiring opportunity,” commented Scott. “Building off the success that this innovative team has already achieved, I look forward to helping Hyperfine make its mark on the world.”
ADVANCING THE IMAGING PROFESSIONAL
RSNA ANNOUNCES PLENARY PROGRAM FOR 2021 ANNUAL MEETING The Radiological Society of North America (RSNA) has announced its plenary session lineup for RSNA 2021: Redefining Radiology. The opening session will be held in Arie Crown Theater at McCormick Place on Sunday, Nov. 28, at 4 p.m. Central time (CT). Other meeting activities will begin Sunday morning, including science and education sessions and the technical exhibits. In her President’s Address during the opening session, Mary C. Mahoney, M.D., will outline what redefining radiology means to her. “The pandemic has uncovered myriad issues in our profession, from inequities in patient access to care to inefficiencies in our workflows,” Mahoney said. “It would be a wasted opportunity to revert to previous operations unreflectively. Rather, we need innovative ways to conduct our work more effectively and empathically.” Mahoney will discuss new ideas and technologies that are redefining what it means to be a radiologist today. It is especially critical to engage in discovering global solutions to challenges facing the medical imaging community while maintaining quality-based and patient-focused care, according to Mahoney. Equally important, she says, is moving forward with a mindset of collaboration, civility, inclusiveness and diversity. James Merlino, M.D., will continue the conversation during the opening session and discuss the strategies employed at Cleveland Clinic to create a state-of-theart patient experience, and how those methods can be adopted by radiologists everywhere. The COVID-19 pandemic has heightened the need for quality health care at an affordable cost that is accessible to all, according to James A. Brink, M.D., radiologist-in-chief at the Massachusetts General Hospital (MGH) and the Juan M. Taveras Professor of Radiology at Harvard Medical School. At his Monday plenary, he will discuss the importance of highlighting the impact of
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radiology services on patient outcomes and quality of life while demonstrating a professional responsibility for appropriate use of medical imaging and image-guided services based on evidence-based guidelines. RSNA’s popular Image Interpretation Session will be held Monday afternoon. Tuesday’s plenary session features Michele Johnson, M.D., professor of radiology and biomedical imaging, professor of neurosurgery and director of interventional neuroradiology at Yale Medicine, and Christine Porath, Ph.D., tenured professor at Georgetown University’s McDonough School of Business, author of Mastering Community (forthcoming) and Mastering Civility, and co-author of “The Cost of Bad Behavior”. Drs. Johnson and Porath will share actionable ways in which radiologists can help to ensure professional, equitable patient care and a thriving work environment. RSNA will also debut a new interactive plenary session on Wednesday featuring a team-based competition in an exciting game show format. Radiation oncology continues to rank among the least diverse specialties by gender and race/ethnicity and trends in Black radiation oncology faculty representation show steady declines since 2006, according to plenary speaker Iris C. Gibbs, M.D., professor of radiation oncology and neurosurgery and associate dean of M.D. admissions at Stanford Medicine. Thursday’s RSNA/AAPM Symposium will highlight the successful collaboration between radiologists and physicists toward technical developments and clinical translations in medical imaging. In the session moderated by Guang-Hong Chen, Ph.D., speakers Cynthia McCollough, Ph.D., and Joel G. Fletcher, M.D., will discuss the importance of imaging technology innovation to today’s radiology practice and providing optimum patient care. RSNA 2021 will be held November 28 to December 2, at McCormick Place in Chicago.
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NEWS MITA REACTS TO FDA APPROVAL OF ADUCANUMAB FOR ALZHEIMER The Medical Imaging & Technology Alliance (MITA) commended the U.S. Food and Drug Administration (FDA) following its decision to grant approval of aducanumab, a move that will give patients access to the first-ever disease-modifying treatment for Alzheimer’s. Considering the decision, MITA also called attention to additional barriers in diagnosing and treating this devastating disease. “The action taken today by the FDA will give patients and caregivers access to the first-ever Alzheimer’s disease-modifying treatment,” said Patrick Hope, executive director of MITA. “Now, the Centers for Medicare & Medicaid Services (CMS) needs to act to update its outdated coverage and payment policies and provide patients with access to amyloid PET diagnostic drugs.” According to the Alzheimer’s Association, more than 6 million Americans are estimated to be living with Alzheimer’s, about half of whom have not yet been diagnosed. But patients cannot get treated without confirming their diagnosis. Though the FDA approved amyloid PET scans in 2012 to allow physicians access to reliable and accurate diagnostic information to inform the care of patients living with Alzheimer’s disease, Medicare does not appropriately cover amyloid PET imaging – which is the most accurate and least invasive way to detect amyloid, a hallmark of Alzheimer’s disease. CMS only provided access to amyloid imaging from 2016-2019 via the lengthy CMS Coverage with Evidence (CED) process. The resulting IDEAS study was the largest Alzheimer’s disease study ever conducted and resulted in a change in a patient’s disease management over 60 percent of the time. In 36 percent of cases, there was a change in diagnosis. Despite these findings, amyloid imaging agents are still not covered unless under an approved CED study. Patients also face a second barrier to diagnosis due to Medicare’s packaged payment policy for precision radiopharmaceuticals, including amyloid PET, which results in significant losses to hospitals with each diagnostic test performed. According to a recent GAO Report, the organizers of the New IDEAS Study highlighted the challenges they are facing recruiting hospitals given the financial barriers. It is important to note that both the current coverage and payment policies for amyloid tracers will pose significant barriers to patient access to this important diagnostic tool. CMS should act immediately to ensure patients have access to amyloid diagnostic testing that assists clinicians in diagnosing Alzheimer’s disease. Knowing this information, patients will receive a more accurate diagnosis, leading to better treatment pathways and outcomes. Importantly, future clinical trials will be assured the most appropriate patients will be included. “CMS should revise the legacy coverage and payment policies that will hinder access to this life-changing treatment,” noted Hope. “Specifically, MITA calls on CMS to expeditiously open the amyloid PET reconsideration request that has been pending before the agency since September 2020 to ensure appropriate Medicare access.”
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FUJIFILM LAUNCHES MULTI-USE RADIOGRAPHY FLUOROSCOPY SYSTEM FUJIFILM Medical Systems USA Inc. has launched the Persona RF PREMIUM in the United States. The Persona RF PREMIUM is an innovative radiography and fluoroscopy system designed for hospitals and medical centers of all sizes, providing real-time imaging for skeletal, digestive, urinary, respiratory, reproductive systems; and specific organs including the heart, lung and kidneys. “Today’s high patient volumes call for a simple, yet highly advanced multi-purpose radiographic fluoroscopy system,” said Hidetoshi Izawa, vice president of modality solutions, clinical affairs, and in-vitro diagnostics, FUJIFILM Medical Systems USA Inc. “With the Persona RF PREMIUM system, medical facilities both large and small can expect an excellent return on their investment with the system’s combination of low dose, optimal image quality, ease-of-use and exam versatility. Fujifilm is proud to expand our cutting-edge medical imaging portfolio to provide hospitals with the technologies they need to positively impact patient care.” Competitive clinical capabilities designed to improve patient comfort include the system’s ability to support patients of up to 584 pounds without any table movement restrictions, and easily adapts for mobility reduced patients. Productivity-enhancing capabilities offered by the Persona RF PREMIUM include an integrated video camera in the collimator, providing the ability to position the patient without using fluoroscopy, and a workstation software that is linked to the table to provide quick automatic positioning, freeing up valuable time for the patient.
ADVANCING THE IMAGING PROFESSIONAL
FDA CLEARS AI-BASED IMAGE RECONSTRUCTION TECHNOLOGY Bringing the power of artificial intelligence (AI) to molecular imaging, Advanced intelligent Clear-IQ Engine (AiCE), Canon Medical Systems USA Inc.’s Deep Learning Reconstruction (DLR) technology, is now 510(k) cleared on the Cartesion Prime Digital PET/CT system and was showcased at SNMMI 2021 for both PET and CT acquisitions. The Cartesion Prime
with AiCE can help clinicians produce high-quality images consistently and routinely, paving the way for improved image quality, the ability to better visualize lesions and possibly reduce a patient’s time in the scanner. AiCE was trained using vast amounts of high-quality data and features a deep learning neural network that can reduce noise and boost signal
to quickly deliver, clear and distinct images, further opening doors for advancements in molecular imaging. An innovative approach to reconstruction, AiCE on the Cartesion Prime Digital PET/CT can provide fast exams at a lower dose with better image quality than traditionally acquired during both the PET and CT acquisitions.
IMAGING SYSTEMS YOU AND YOUR PATIENTS DESERVE From adding another MRI unit to handle your patient backlog, to providing a short-term solution while upgrading your current unit, to adding a new service, KMG has the right imaging systems to keep you running efficiently and affordably.
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NEWS IMAGING BIOMETRICS AWARDED PATENT IQ-AI subsidiary Imaging Biometrics (IB) was awarded a U.S. patent for its artificial intelligence (AI) software technology that eliminates the need for gadolinium-based contrast agents (GBCAs) in medical imaging exams. A zero-dose exam potentially offers remarkable benefits which include a more comfortable patient experience, more productive radiology departments and reduced risks associated from the long-term, albeit uncertain, side effects of repeated GBCA use. The fully automated AI technology, called IB Zero G, accepts non-contrast medical images as inputs and produces a synthetic image series that mimics contrast-enhanced images of comparable diagnostic quality. Currently in the investigational stage, IB Zero G is compatible with all magnetic resonance imaging (MRI) scanner platforms. By eliminating the need to acquire a contrast-enhanced series, IB Zero G means less time in the scanner for patients. And for health care systems, IB Zero G provides increased scanner availability and a reduction in gadolinium expense.
Standard Contrast
Zero Contrast
“This patent underscores the major impact AI applications can have in health care,” said Michael Schmainda, CEO of IB. “IB Zero G has the potential to significantly disrupt routine clinical workflows on a global basis and help millions of patients receive higher quality and safer MR exams.”
Save The Date! THE CONFERENCE FOR IMAGING PROFESSIONALS
ICE2022 IMAGING CONFERENCE & EXPO FEBRUARY 20-22, 2022 • NAPA, CA
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ADVANCING THE IMAGING PROFESSIONAL
RESEARCH: ONCOLOGISTS MORE COMFORTABLE WITH CAR-T THERAPY Four years after the approval of the first CAR-T cell therapies, oncologists are referring more patients for treatment and becoming more comfortable with the cost. However, payer approvals and cumbersome administrative processes are still key barriers, according to new research published from Cardinal Health Specialty Solutions. CAR-T cell therapy uses the body’s own immune system to fight cancer. It works by taking blood from patients and separating out the T cells, then genetically engineering them to produce chimeric antigen receptors (CARs) on their surface, which can target and kill cancer cells. Today, there are five CAR-T products approved in the United States (U.S.) for seven different indications including various lymphomas and multiple myeloma. The perceptions and current use of CAR-T therapy by oncologists are explored in the latest edition of Oncology Insights, a biannual research-based report series authored by Cardinal Health, analyzing surveys of more than 300 U.S. oncologists. The surveys were conducted between February-April 2021, culminating in the report’s publication. “The innovative science behind cell therapies like CAR-T is transforming the long-term outlook for many cancer patients. Our latest research shows that, despite some barriers to access, oncologists are embracing these new therapies
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and are optimistic about their continued use in the future of oncology care,” said Heidi Hunter, president of Cardinal Health Specialty Solutions. The study finds 60% of participating oncologists say that CAR-T therapy costs are either “reasonable” or “not inappropriate” versus just 39% of respondents in a similar 2017 study. In addition, 91% of oncologists have referred at least one patient for CAR-T therapy over the past 12 months, up from 54% and 71% in surveys conducted in 2019. In addition to assessing views about CAR-T, the report also explores the continued impact of COVID-19 on oncology and discusses performance in value-based care. These key findings identified: • About two-thirds of participating oncologists report delays in routine cancer screening due to the COVID-19 pandemic; • 89% of participants expect to continue using telemedicine after the end of the COVID-19 pandemic; • nearly four in 10 participants said it is difficult or very difficult to perform well under value-based care models; and • one in four participating oncologists agree that current technologies support success in value-based care.
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NEWS
ICE
A COOL SERIES FOR HOT TOPICS
Webinar Addresses Capital Costs and Patient Care Improvements STAFF REPORT
T
he ICE webinar “Reduce Capital Costs and Improve Patient Care with a Comprehensive Technology Assessment Program” sponsored by Accruent was approved by AHRA for 1.0 Category A ARRT (AHRA Reference: END11285; Expiration Date 6/23/2022). In this webinar, experts Al Gresch and Patrick Trim shared a better way to optimize capital spending and avoid unnecessary expenses with a comprehensive technology assessment program. Every health care organization is faced with scarce capital funding, especially in this COVID-19 recovery period. In addition, inadequate scoping and planning of large capital acquisitions translate into even more unplanned expenses and delayed openings that hospitals cannot afford. The presenters shared why it’s important to have a technology assessment program and how to successfully convey the benefits of the program to hospital leadership. They also discussed how to develop and structure a successful technology assessment program. The duo also presented real-life results of a director of technology assessment role. Attendees gained additional knowledge during an informative question-and-answer session. One question was, “Your presentation sounds great in theory, but most of us struggle with getting support from our CFO. In practice, has this worked?” “It’s worked. I’ve done it in 2 or 3 different hospital systems,” Trim replied. “As I tried to stress in the presentation, it’s very important to have your ducks in a row. It may take 26
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Al Gresch
Patrick Trim
three to four to five, even six months to put all this together, but it’s work that’s really needed to be able to sell it. FTEs are a premium. Everybody on this call knows that, and it’s important to have that pre-work done if you’re going to make this happen.” “So, it’s been done,” he added. “It just takes a lot of work.” Attendees provided feedback via a survey that included the prompt, “Give us three words to describe today’s webinar.” • “ Packed with solutions,” Mammography Care Coordinator A. Harris said. • “ Effective, analytical, informational,” is how Director of Radiology N. Godby described the webinar series. • “ Equipment replacement justification,” said Imaging Director D. McGill. Thank you sponsor!
For more information, visit ICEwebinars.live. ADVANCING THE IMAGING PROFESSIONAL
1 2 3 Register online to view our live webinars each month.
ARRT Category A CE credit is pending approval by the AHRA.
Watch recorded webinars online.
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Market Report Trends Boost AI Growth STAFF REPORT
G
raphical Research recently added a new artificial intelligence in health care market report that provides in-depth information including market highlights, product types, drivers, challenges, trends, industry landscape, size and forecast. Artificial intelligence (AI) is a form of advanced technology that performs complex tasks, which normally would require human intelligence, with ease. This field is constantly undergoing innovations since its inception and has become far more advanced today. AI has heavily contributed to various fields, one of the most important among them being health care. This technology has immensely helped in improving patient care and other important management processes in hospitals. AI has played an active role in providing early diagnosis and commits littleto-no errors while providing the same. It has helped health care professionals in making sound decisions about the right mode of treatment and medication to prescribe. Big data analytics have been put in place as well which will help the staff in handling important paperwork and help keep track of the same. The global health care (AI) market will grow substantially by 2027, according to market statistics. Some of the trends that will encourage the growth of this industry is the growth of the 28
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geriatric population in North America. It is increasing every year. This has led to increased demand for advanced health care facilities in the region. There are constant innovations being done in the regional artificial intelligence in health care market. They include providing improved and personalized patient care and early diagnosis of serious illnesses. AI has positively impacted the health care infrastructure in the U.S. with the introduction of digitization, AI/ ML frameworks and cloud computing platforms. It has significantly contributed toward patient care as well because it helps in the appropriate recovery of patients. It has helped fill important gaps health care. Machine learning is predicted to gain momentum through 2027 in health care, according to market experts. This is because it has a wide range of applications in health care. It is extensively used in precision medicine and even prescribes customized treatment alternatives for a patient. For example, Mayo Clinic, in January 2017, announced a collaboration with Tempus to create personalized care for cancer patients with the help of this technology. This partnership aims to study the different forms of cancer like lung, breast and bladder and provide solutions accordingly. The medical imaging and diagnosis segment will reportedly grow at a CAGR of 46% in the coming years. The reason for this is being credited to the many benefits AI has in this segment. Some of these are easier identification
of complex patterns in imaging data and the ability to provide quantitative results of radiographic features. According to an article published by the National Center for Biotechnology Information (NCBI), AI has successfully and significantly contributed towards various fields like thoracic imaging, colonoscopy, radiation oncology, mammography and many others. The artificial intelligence in health care market in China was valued at $70 million in 2020. This figure is expected to go even higher in the years to come as the country is known for integrating AI with traditional industries. It is one of the few developing countries that is investing heavily in advanced technologies and has the most AI hubs as well. The country is going through a phase of national digitization in its health care industry. AI in this industry is used in several fields like drug development, online consultations, health management and many others. In 2018 alone, China’s investments in health care AI touched $1 billion and it had already signed over 66 deals in this regard. There are several policies introduced by the Chinese government as well that will benefit the health care AI industry. For example, the Beijing Kunlun Medical Cloud Technology Co. Ltd received the approval from the National Medical Products Administration (NMPA) for DeepVessel FFR. This is a computer tomography technology developed with the help of AI and is non-invasive in nature. ADVANCING THE IMAGING PROFESSIONAL
Product Focus Artificial Intelligence
ALGOMEDICA PixelShine
PixelShine by Algomedica was developed using machine learning. It can improve the quality of any CT exam by reducing the inherent image noise during the image reconstruction process. This is particularly applicable to ultra-low dose CT scanning applications such as lung screening. Pixelshine empowers health care providers to acquire high-quality CT scans using substantially lower radiation dose. PixelShine is vendor agnostic and can enhance the quality of noisy CT scans acquired by all types of CT scanners, including older and refurbished models. PixelShine is fast, requires no user interaction and can be remotely installed. For more information, visit algomedica.com.
CARESTREAM
Imaging Intelligence and Workflow Intelligence
Carestream provides robust artificial intelligence solutions to help improve diagnostic image quality and radiographer throughput. Carestream’s Eclipse Imaging Intelligence capabilities offer robust processing and images of optimal quality – while reducing quality errors and increasing dose efficiency. The latest offering is Smart Noise Cancellation (SNC) that leverages AI to provide improved anatomical clarity, preservation of fine detail and better contrast-to-noise ratio for images acquired at a broad range of exposures. Timesaving, automated Workflow Intelligence solutions streamline processes, support technologist productivity, save time and money and enhance patient care. Advanced features include Smart Auto Position, Smart Collimation and Smart Technique. For more information, visit carestream.com/eclipse-ai WWW.THEICECOMMUNITY.COM
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PRODUCTS
FUJIFILM REiLI
The complexity of new imaging advancements has triggered the need for an AI co-pilot; one that can help take on some of the overwhelming imaging demands placed on diagnostics professionals. Using extensive machine learning algorithms from Fujifilm, vendor partners and academic research institutions, Fujifilm’s REiLI brings unprecedented AI insights directly within the workflow of Synapse PACS users, helping to enhance diagnostic accuracy, streamline efficiency and seamlessly support those on the diagnostic frontlines.
GE HEALTHCARE AIR Recon DL
Now available on GE Healthcare’s SIGNA 7.0T ultra-high-field MRI, AIR Recon DL is the industry’s first deep learning image reconstruction technology that works across all anatomies. Since it first launched on GE Healthcare’s 3.0T and 1.5T MRI scanners, AIR Recon DL has benefited over a half a million patients around the world, improving the patient experience through shorter scan times while also increasing diagnostic confidence with better image quality. Feedback from clinical users has been overwhelmingly positive, including observations of sharper and less noisy images as well as a 30-50% reduction in exam times.* * GE Healthcare data on file.
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ADVANCING THE IMAGING PROFESSIONAL
LAUREL BRIDGE SOFTWARE
AI Workflow Suite (AIWS) The explosion of AI algorithms and the need to integrate them into existing clinical imaging workflows was a primary catalyst in Laurel Bridge Software announcing its AI Workflow Suite (AIWS). AIWS automatically identifies, fetches, anonymizes and delivers current and relevant prior studies to AI algorithms. After receiving the AI algorithm results, AIWS also reidentifies and distributes the results to the appropriate locations. • AIWS provides the following benefits: • Integration of study data between AI algorithms and clinical systems and workflows • Seamless interoperability between local facilities and cloud-based AI algorithms • Standards-based interoperability with third-party applications and clinical systems
SIEMENS HEALTHINEERS AI-Rad Companion Organs RT
AI-Rad Companion Organs RT, the latest Siemens Healthineers artificial intelligence-based software assistant in the AI-Rad Companion family, uses deep-learning AI algorithms to automatically contour organs at risk (OARs) on computed tomography (CT) images as part of the radiation therapy planning workflow. These algorithms automate the organ contouring process for various body regions, including the head and neck, thorax, abdomen and pelvic regions, to accelerate contouring. AI-Rad Companion Organs RT also supports the use of organ template configurations that can be aligned with institutional protocols, which may save time and improve standardization in clinical workflows. AI-Rad Companion Organs RT is available on the company’s teamplay cloud-based digital health platform.¹ ¹ teamplay is not yet commercially available in all countries. For regulatory reasons, its future availability cannot be guaranteed.
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Where in the Hype Cycle is Radiology AI? BY MATT SKOUFALOS
I
n the world of medical imaging, the promise of artificial intelligence (AI) has ranged from the apprehensive (“AI is going to replace the radiologist!”) to the incredulous (“There’s no way we’ll see AI in our practice any time soon!”) so frequently that it can be difficult to know what’s real and what’s imagined. In the “hype cycle” of the technology, a graphic representation of the maturity of emergent technology created by the market research firm Gartner, is AI pushing towards the Peak of Inflated Expectations? The Trough of Disillusionment? The Plateau of Productivity? 32
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Peter Shen, vice president of innovation and digital business at Siemens Healthineers North America, acknowledges that “there is certainly a bit of expectation or promise around artificial intelligence” in medical imaging, “if for no other reason than it’s been a buzzword for the past several years.” Amid growing expectations that AI-driven technologies will deliver on promises to increase workflow efficiencies or enable better clinical diagnoses, Shen said what medical imaging is struggling to realize “industry-wide, and clinically,” is the practical reality of how to incorporate AI into daily clinical routines. For a start, there’s the challenge of financial motivation: Shen describes hesitance among providers and clinicians to ADVANCING THE IMAGING PROFESSIONAL
invest in (or ask for) AI-driven devices and systems without knowing what the return on that investment might look like, or without knowing whether any financial incentive to implement it may exist among health care providers or the federal government. “The clinician isn’t necessarily paying out of his or her pocket for the AI solution to be implemented,” Shen said. “It’s up to the imaging department to have to procure these kinds of solutions, and a lot of departments really struggle with making the investment into AI because the quality metrics or throughput expectations around AI aren’t really there yet. A lot of the whitepapers around AI are focused on the clinical competence around AI, and the operational competence has yet to be addressed: any sort of reimbursement or payment done around these studies is very far and few between. Institutions won’t make an investment in AI unless they can determine how they’ll recoup it.” WWW.THEICECOMMUNITY.COM
Another key consideration for Shen is how providers will integrate AI technologies into their overall daily clinical workflow. Some initial forays into AI have focused on enhancing image detection and the identification of malignancies within a study. Determining what to do with this information reflects the next promise of AI, which is powering patient screenings to further help radiologists make accurate diagnoses. “What clinicians desire now is the ability to have those algorithms run in the background before those studies are presented to them,” Shen said, “and then expanding that AI to prioritize which cases need the most immediate attention. In the ideal world, the AI has gone through the exams, identified the patients who have something urgent to look at, and those are floated to the top of those cases to review. We’ve heard from several different providers that AI is being used right now for a lot of diagnostic work, but that in the screening environment, it would be great to be able to identify or triage certain patients who might then need some sort of follow-up exam because something’s been detected. There’s a strong desire to move AI beyond this diagnostic tool into screening or triaging a patient and rule out some things.” AI is also the hook upon which many have hung their expectations that the technology will help to close a growing gap between the number of cases that must be interpreted and the availability of radiologists to interpret them. The more wide that gap broadens, the less time available for each clinician to dedicate to investigating any single case, no matter how severe. As Shen puts it, “If radiologists have 100 exams today, but
200 tomorrow, and the same amount of time to review them, they might only have half as much time to interpret each exam.” If AI can help cut down on some of the time they spend preparing an exam for interpretation, but make that time spent more meaningful to the outcome of that effort, the technology will be a welcome addition to their practices. Some of the ways in which that prep time could be shortened involves the advanced processing capability of an AI-powered workflow system, Shen said; some of it involves automating “the handshake from image acquisition from CT or MR to the way that the individual radiologist wants to be able to visualize the relevant AI findings of that exam” for the best interpretation of the results. “Algorithms can help automatically do the identification, characterization and measurements associated with the
“Algorithms can help automatically do the identification, characterization and measurements associated with the abnormality found within an image.” – Peter Shen
abnormality found within an image,” Shen said. One of the reasons Shen believes the medical imaging industry hasn’t fully embraced AI is that in order to integrate its automated processes into radiology workflows, radiologists must change the way they’ve done their work for years already. The expectation that AI will save time and effort must ICEMAGAZINE
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Where in the Hype Cycle is Radiology AI?
be tempered by the learning curve involved in adapting to those changes, especially when it comes to the individual approaches each clinician takes to his or her diagnostic processes. “Now that we have these solutions that can help us with these tasks, the additional information being generated is something the radiologist has to consider,” Shen said. “That’s a little bit challenging. Radiologists know that their role in terms of the patient’s care and clinical journey has to evolve as well. Part of that means that they have to become a more informed clinician to be able to make a more informed diagnosis for the patient.” The ability to leverage AI to present a larger, clearer picture of patients and their medical conditions represents a function that could unlock some of the biggest promises of the technology – namely, its ability to retrieve personal medical information beyond what’s presented in the imaging study itself and inclusive of electronic health records, lab results; even genomic and genetic data. Shen argues that if radiologists had access to all that information alongside patient images, they could return more comprehensive and accurate diagnoses. There’s even consideration given to leveraging AI-informed patient profiles to create “digital twins” of patients that could be used to simulate different data points and make diagnostic or therapeutic decisions that can be tested virtually to predict the response in the patient. But in order for any of those abstractions to be realized, they must build confidence that the technology will reach the right clinical conclusions, Shen said. This involves careful consideration of the data sets upon which the algorithmic knowledge is built. “It’s one thing to feed those AI 34
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algorithms with a million different images that show a big abnormality in the chest, and then that algorithm can easily identify that abnormality because we’ve trained it a million times,” Shen said. “But the challenge is to also consider training the algorithm with the curated results or reports or clinical background behind every one of these images.” “What was the outcome of that nodule?” he said. “Was it malignant? Was it benign? How did it change over time? There’s additional data around
“AI won’t replace the radiologist, but the radiologist using AI will replace the radiologist not using it.” – Maryellen Giger
the complete history of the image, so that as the algorithm starts to learn and draw its own conclusions, there are more data points from which to make a more informed decision.” “As you feed and train these different algorithms, they can’t come from the same patient cohort; they have to come from a diverse cohort of patients with all sorts of clinical backgrounds, whether they be genetic or whatever the case,” Shen said. “It’s got to have a diverse data set to create this clinical algorithm that you’ll have confidence in. As we’re starting to embrace AI, in order for everybody to feel comfortable, we need to make sure the algorithms are trained with as much
complete information about the patient as possible.” On that front, “We have a lot of work to do,” said Kris Kandarpa, director of research sciences and strategic directions and acting director of the division of applied science and technology at the National Institute of Biomedical Imaging and Bioengineering at the National Institutes of Health. Although the U.S. Food and Drug Administration has begun to certify certain AI-powered medical imaging algorithms for the detection of certain diseases, so far only 21 of those have been approved in the radiology space. According to a September 2020 study by Stan Benjamens, Pranavsingh Dhunnoo and Bertalan Mesko published in the Nature partner journal Digital Medicine, six of those algorithms are rooted in oncology, two are focused on brain imaging, and six work to improve image processing by reducing radiation dosage and “noise” on images. Four are focused on acute care, and two others on cardiovascular assessments. In addition to the limited number of conditions and circumstances in which AI-powered technologies are being applied to clinical diagnoses, Kandarpa also points out that “the data sets that these algorithms train on are very small, and not very diverse;” hence the work yet to be done to enhance them. “These algorithms that are coming out have to be generalizable,” Kandarpa said. “They have to be useful regardless of where they are employed. Newer algorithms should help solve problems in ways that a human might not do; not only interpreting individual images and predicting population health trends but also supporting workflow and work efficiency.” ADVANCING THE IMAGING PROFESSIONAL
During the novel coronavirus (COVID-19) pandemic, researchers also worked to apply AI-powered techniques to the diagnosis and management of COVID-19 patients. At the University of Chicago, NIBIB was joined by the American College of Radiology (ACR), the Radiological Society of North America (RSNA) and the American Association of Physicists in Medicine (AAPM) in establishing the Medical Imaging and Data Resource Center (MIDRC). MIDRC hoped to leverage AI processes to deliver faster, more reliable diagnoses of the impact of COVID-19 on patients by drawing upon what physicians knew about the variety of ways in which it affected patients. “It’s more than a chest problem,” Kandarpa said. “We know now that many organs are being affected, and we will have, in the future, a way of monitoring COVID and chronic COVID in the long-haulers. Since COVID unfortunately affects many organs, MIDRC is also developing a knowledge base for all organs that should be applicable to other diseases that may also affect those very organs.” Maryellen Giger, a principal investigator at MIDRC (midrc.org) and the A.N. Pritzker Distinguished Service Professor of Radiology, Committee on Medical Physics, and the College at the University of Chicago, said it is important to note that identifying COVID-19 data from imaging studies is just the beginning of what the MIDRC collaboration could deliver. It’s about properly collecting and curating medical imaging data sets to drive robust, unbiased AI development, harmonizing diverse image presentations provided by different institutions and standardizing their output for clinical end users. Furthermore, MIDRC is also compilWWW.THEICECOMMUNITY.COM
ing sequestered data sets that can be used to independently test machine learning algorithms in the future by showing them images they’ve never seen before. Extremely important, Giger notes, is that MIDRC is co-led by three, Peter Shen Maryellen Giger major medical imaging Vice President of Innovation Principal Investigator at and Digital Business at MIDRC and the A.N. Pritzker entities (ACR, RSNA and Siemens Healthineers Distinguished Service AAPM), benefitting from Professor of Radiology, Committee on Medical their combined expertise Physics, and the College at in both the clinical and the University of Chicago technical aspects of the medical imaging field. “What MIDRC is achieving actually could affect all of ness to share data. Having institutions medical imaging,” Giger said. “We have across populations contribute their radiologists and imaging scientists imaging data to MIDRC is crucial in from universities, community practices, order to develop and demonstrate the government labs and FDA on various robustness of algorithms across difworking groups. We have technology ferent platforms and populations, and development projects that create the that’s our aim with MIDRC.” infrastructure, but we also have collaboCharting a course for that same, rative research projects.” broad integration of machine-learning “Having everyone work together in technologies, clinical analysis strateMIDRC – RSNA, ACR, AAPM – it’s never gies, and of various medical imaging been done before,” she said. “With leadership groups is really what will these societies working together, we advance the adoption of AI in medical span medical imaging expertise, and imaging, and Giger believes that’s a job we span the country.” that radiologists are distinctly posiTo make the most of any gains in tioned to do. medical imaging, device manufacturers “Radiologists are going to be don’t only need to collaborate on the integrators of knowledge,” she said. development of AI-based technologies, “They have to integrate the clinical but they must also work to certify that history, the image, and other factors, the AI output can be obtained across and then give a recommendation for a variety of competing, proprietary patient management. Part of that will systems to yield usable, unbiased deciinclude integration of AI and non-AI sion-making tools. sources.” “That is, if the software works, does Or, more succinctly, as Giger said, it work correctly in a Siemens system, the common wisdom that “AI will in a GE system?” Giger said. “Usualreplace radiologists” has evolved: “AI ly, the hold-ups aren’t the technical won’t replace the radiologist, but the expertise, but rather the policies, the radiologist using AI will replace the data-use agreements, and the willingradiologist not using it.” • ICEMAGAZINE
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SPONSORED CONTENT
A CLOSER LOOK INTO IMAGING DIVERSIFIED I By Erin Register
maging Diversified was founded by current owner and CEO Nathan Smith. Together with two colleagues, Smith decided to expand and grow visibility in the MRI training profession. The idea first transpired from the organic joy of teaching and helping other MRI technologists in the field. The thirst for knowledge and then sharing that knowledge with others to enhance their capabilities within the MRI profession ignited a passion to do more. Through many years and opportunities to offer training education to co-workers for employers, Smith noticed that trainers were as good as their passion to train. Some application specialists were great and others not so good, which led to Smith having to redo the training. The need for great application specialists, especially for third-party vendors, was needed. Smith wanted to fill the void. With that thought, Smith reached out to a few vendors and offered his services at the market rate. The goal was to offer higher quality training, complete protocol implementation and help the technologists get a better understanding of their equipment. The idea to market and create a social media presence was presented, and the formation of Imaging Diversified LLC was created. The company officially launched in January 2020. 36
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“We have grown to employ five MRI application specialists and two CT applications specialists,” said Smith. “We also have expanded from just doing training to fulfilling multiple services in the radiology field for both the vendor and customer (imaging center/hospital).” ICE learned more about Imaging Diversified in an interview with Smith.
Q: WHAT IS THE MAIN FOCUS OF IMAGING DIVERSIFIED? A: Our focus is to provide the easiest solutions for radiology from start to finish. Training of staff and management is our main focus. If we can improve the knowledge of the radiology team from top to bottom, they will then in turn save more money, improve efficiencies and enhance the group as a whole. Not to mention, we offer training to vendors that can accompany upgrades and new equipment purchases.
Q: WHAT SERVICES DOES IMAGING DIVERSIFIED OFFER? A: Our company offers a variety of services. First, to all vendors, third-party and OEM, we offer our application training services. When we are out in the field, we help to ensure the customer knows how to operate the new equipment they have just purchased. We also offer support to customers that may want to figure out exactly what equipment is right for their radiology
Nathan Smith, Owner/CEO Imaging Diversified
organization, as well as finding the right service contracts for these groups, sometimes saving them thousands of dollars. We also have financing options available, offer short-term staffing requests, virtual management solutions, daily applications support, workflow optimization, help with hiring, development and help with ACR accreditation.
Q: HOW DOES IMAGING DIVERSIFIED STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: We stand out by being a company that offers solutions to both vendors and customers alike. We ADVANCING THE IMAGING PROFESSIONAL
not only offer services but work with the company to overall improve the functionality in the radiology department as a whole. We have a core group of employees that currently work in radiology, from directors to technologists, that can offer their expertise with real world knowledge. This advanced knowledge with our core helps us to bridge the gap for other imaging centers, hospitals and radiology groups that want to save money while running in the most efficient manner. Overall, improving the customer satisfaction level and enhancing the patient experience is why we stand out.
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CODING/BILLING BY MELODY W. MULAIK
BILLING FOR SPOT IMAGES (OR NOT)
I
n some practices there are situations that arise where the radiologists are asked to interpret images, aka “spot” images, in conjunction with other procedures, typically performed by other specialties. Before getting to the coding of these procedures it is first important to ask why the radiologists are reviewing the images. Is there really an order for them to interpret the study or are they reviewing the images simply because they are in their PACS work queue? Other issues such as contracting and hospital policies may also come into play. If there is not an order and/or their interpretation is just filed and not really used by the other physician to provide care to the patient, then the service should likely not be billed. Following are some common scenarios that many practices encounter for spot images. When spot images are taken during a procedure performed by a radiologist, the radiology group should bill only for the procedure’s surgical component and radiological supervision and interpretation (S&I) codes. The radiological S&I includes interpretation of any spot images obtained during the procedure. WWW.THEICECOMMUNITY.COM
It would not be appropriate for the radiology group to submit both the S&I code and additional codes for interpretation of spot images. In situations where a radiologist is asked to interpret spot images taken during procedures performed by non-radiologists it is not appropriate to assign fluoroscopy code 76000 since the radiologist was not present to supervise the imaging. (CPT® Assistant, September 2014) It doesn’t happen often but, in some cases, there is a CPT® S&I code for the procedure being performed by the non-radiologist. For example, code 74330 represents the radiological S&I for endoscopic retrograde cholangiopancreatography (ERCP), a procedure that is usually performed by a gastroenterologist. The Medicare Claims Processing Manual (Chapter 13, Section 80) states that the radiologist should apply modifier 52 to the S&I code when billing for interpretation of images that the radiologist did not supervise. The physician who performed the procedure should also apply modifier 52 to the S&I code because he or she supervised the imaging but did not interpret it. The majority of the time there is no S&I code for the imaging guidance. For example, the radiologist may be asked to interpret spot images taken during a spinal fusion or knee replacement procedure. According to Clinical Examples in Radiology (Winter 2013),
the radiologist “should report an X-ray code for the anatomic area imaged” – for example, the spine or the knee. Sometimes a surgeon will submit several spot images that were taken in the same projection at different points during a surgical procedure. Because these images all represent the same view, it is not appropriate to assign a code for a multi-view exam. Also, because the images are all interpreted together at the conclusion of surgery, rather than being interpreted individually during the surgery with immediate feedback to the surgeon, they should be considered a single exam rather than separate exams. For example, simultaneous postop interpretation of three lateral cervical spine images taken during spine fusion surgery should be reported as one single-view exam (72020) rather than three single-view exams or one three-view exam (72040). If it is appropriate to bill for these studies, you do not want to miss appropriate revenue. Conversely, it is important to ensure that you are not billing for studies inappropriately. Revisiting this concern on an annual basis is good practice from a revenue and compliance perspective. • MELODY W. MULAIK, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle and Coding Strategies Inc.
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INSIGHTS
AI CAN’T REPLACE EMOTIONAL INTELLIGENCE
A
s artificial intelligence (AI) has emerged and will progress to make image production and interpretation more standardized and efficient, I would like to make a point regarding the emotional intelligence that will never be replaced by a computer.
DIRECTOR’S CUT BY BETH ALLEN
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Over the years, I have experienced situations as well as heard from many others, where intuition tells you to question the facts or do something more than is normally required. As humans, we can pick up on verbal or physical cues that help us assess the situation. Many patients come into our medical imaging department not really understanding why they are there or what test they are going to have done. They have given a brief description of their condition to their ordering provider, which was then entered into a tablet for the EMR. Often symptoms are selected from a drop-down menu to save time. While in the office with their physician, they can be intimidated and forget some key information that would have been helpful to know when deciding on what imaging would be beneficial. Once these patients get into the room with a technologist, they may remember a detail or two that may make a difference in their diagnosis. They may share something with the ultrasound tech that helps direct the imaging that is performed. They may
state they thought they were also supposed to have another exam that had not been scheduled. There may be a mention of a prior surgery or procedure that will make a difference in the protocol that is used. It may just be a look in their eyes or a twinge when touched that will tell a tech that the pain may be more severe than the patient wants to admit. There is still an art to radiology. AI has come a long way. Deep machine learning will continue to help us be efficient in our workflows, protocols and equipment issues. It is still, and will always be, important that we, as professionals, are paying attention to the information we have when we begin the study; what we learn while completing the study; and what we know after the study. Does the script give all the information we need? Is it accurate? Does it gel with what the patient is telling us? Does it seem that what is ordered is appropriate? To take a couple of moments to make sure that we are connecting with our patient and listening to what they have to say will truly make a difference in their care. It is not all plug and play – a flow chart if you will. Each patient is unique and while we have done this same exam 1,000 times, it may not ever have been done for them. I am not implying that techs should be questioning an ordering provider. It just makes sense to pay attention to our part of the process and be on the look out for ADVANCING THE IMAGING PROFESSIONAL
errors. The difference between a sentinel event and a “good catch” may be just one more human taking an extra second to verify the details. Patients need us to keep the human element in radiology. We have big equipment, fancy computers and technology that has replaced the “index card” radiology record that we had at my first job. Maybe something tells you to hold this patient until you can have a radiologist look at the images. Maybe you look through the clinical notes to determine if the correct protocol was ordered. Maybe you just listen to a patient to ensure they feel heard and taken care of. Maybe it is something you see on an image, that moves you to call the radiologist directly regarding an unexpected finding. These are things that make medical imaging a rewarding career. Don’t let technology or “going through the motions” steal the humanity and creativity that has always been the appeal of medical imaging for me. The human connection, the critical thinking/problem solving and pride you feel when you know you have made a difference for someone cannot be replaced by a computer. I love all the ways that we have advanced and I am fascinated by the possibilities to come. I am intrigued by how the technology works, and I have always loved to learn new things. I love people more. Be the difference. Thanks for all you do. •
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INSIGHTS
TEAM BUILDING 201: THE ROLE OF A LEADER
I
EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI
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n my July column, titled “Team building 101,” I outlined six factors that I believe are necessary to build an effective team. To provide readers with more nuts and bolts of how to build a vibrant team, I decided to take a deeper dive into each of the factors. In this column, we’ll examine team leadership. Through experience and professional observation, I firmly believe teams work better when they have a leader. Small teams of two or three people can function nimbly and address issues quickly without a leader, but the larger a team gets, the more a leader is needed. A truth that applies to all team leaders is that multiple hats are the norm. It’s not uncommon for team leaders to function as supervisors, trainers, leaders, managers and even front-line workers. Knowing the responsibilities corresponding to each hat and when each hat needs to be worn is important if the team leader wants to be successful. Another universal truth is that leaders should be passionate about the vision and mission of the team. The power of what I call “water cooler conversations” applies here.
Team leaders should regularly weave the principles of the team’s vision and mission into day-to-day conversation with team members so that the concepts become deeply embedded in the team’s fabric. If a team does not have vision and mission statements, the leader should work with other team members to create them. Involving everyone on the team in this effort is important, as team members don’t usually buy into what they perceive as ivory tower dictates. By way of review, a vision statement outlines where the team sees itself being, and a mission statement outlines what the team will do to achieve the vision. Shorter, one sentence statements are better, because paragraph-long statements are easily forgotten and usually ignored. Team leaders must also assume the managerial responsibility of learning the interests, attitudes and values held by each team member. The leader should also understand each team member’s capabilities as well as each person’s goals. Each person has unique motivations, too. This is important because what drives one person will not necessarily drive another. If a leader simply goes through the motions on all this, the effort will fail. People will see through it. A leader does best if he or ADVANCING THE IMAGING PROFESSIONAL
she views each person as an invaluable asset and places those assets where they can feel most productive. A common reason people give for disengaging or quitting is they feel like their talents are not being used. If you think about it, investors take great care of their valuable assets. Art collectors don’t leave their paintings in the rain, and people holding bearer bonds don’t walk around with them stuffed into their back pockets. If our employees are truly our most valuable assets (and they are), then they need to be treated as such. A good framework for learning about the strengths, blind spots and motivations of people is to use the model of head, hands and heart. “Head” refers to cognitive style, which includes how a person perceives and processes information. It also considers how people prefer making decisions. “Hands” refers to behavioral style, such as how a person responds to problems and challenges. It also includes a person’s preferred work pace, how much one likes to follow or not follow rules, and to what degree one is driven to influence others. “Heart” refers to one’s motivations. Two types of motivation exist; natural and learned. This part of the framework requires a leader to become a student of what drives people, but if creating a vibrant team is the goal, then becoming a student of this facet is a valuable endeavor. Next let’s address what I call “roles and goals.” Each team member should have a well-defined role, which could also be called a specific set of responsibilities. With that, each person should be working on a specific set of goals. As with the vision and mission statement, goals should not be handed down from on high. People are much more engaged when they are participants in the goal setting process, so involve them in creating their goals. After that, it’s vital for leaders to maintain regular communication with team members. Regular emails and phone calls throughout the week ensure that the gears of communication stay lubricated. I cannot emphasize WWW.THEICECOMMUNITY.COM
enough the need for regular communication about projects and ensuring everyone understands the deliverables. Millions upon millions of dollars are wasted each year because of poor or non-existent communication. Along these lines, I especially want to emphasize the value of face-toface conversations. If team members can’t meet face-to-face, a video call or phone call is the next best thing. With so many teams operating remotely these days, the dynamic, real-time voice is much more effective and strengthens relationships better than a text or email. A clear understanding should exist between a team leader and team members on how frequently to stay in contact and what topics should be discussed. Since billions of dollars are wasted each year due to poor communication, team leaders should talk with each team member to learn his or her preferred communication methods. In addition to regular communication, it’s also vital for team leaders to connect with each team member every two or three months for a slightly more formal review of one’s goals. Jobs and situations can change, so better to stay on top of things and keep momentum flowing in the right direction. Finally, keep in mind that team leaders can be builders or climbers. Climbers are those who climb on the backs of others to achieve promotions or status, whereas builders are those who invest in others, equipping them to be better. If team leaders act like builders and build up the people on their teams, they are much more likely to create a vibrant, can-do team. Think of it this way: the leader creates the weather. Good leaders take that responsibility seriously.
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Daniel Bobinski, M.Ed. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years, he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him on his office phone, 208-375-7606, or through his website, www.MyWorkplaceExcellence.com.
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AI: SEEING WHAT’S NEXT L
ast month, I wrote about market forces that are leading to a transformation in the practice of radiology.
AI systems utilizing EHR data can detect previously unknown drug interactions, adverse drug events and new functions of existing FDA-approved drugs. AI systems for genomic data can estab1. Radiology practice consolidation lish previously unknown correlations be2. 5G networks tween diseases and genotypes. For clinical 3. Improved algorithms operations, AI algorithms can transcribe a 4. Institutional IT infrastructure to support doctor-patient conversation in real-time into “learning organizations” like Johns Hopclinical notes and then further convert them PACS/IT kins into structured codes in EHR for clinical deciBY MARK WATTS 5. Team-based care, Mayo Clinic model sion support and billing, thereby reducing the 6. CMS policies physician’s workload and facilitating more I missed the most important one – money. direct patient-doctor interaction. The return on investment (ROI) for AI adoption will be acWe are in the throes of a fundamental economic and celerated by the New Technology Add-on Payment (NTAP). societal transformation. NTAP is a recognition that current payment rates can be The Agricultural Revolution that took place around a barrier to adopting new technology. 10,000 BC liberated people from food insecurity via farming; NTAP is an additional payment for hospital stays that use the Industrial Revolution that commenced 200 years ago new technology determined by Centers for Medicare and began to free people from grueling physical labor through Medicare Serves (CMS). machines; and the AI revolution occurring now is liberating Recent breakthroughs in artificial intelligence (AI) and people from cognitive labor through powerful computmachine learning are enabling doctors to see and also preing, universal connectivity and massive data. While AI has dict previously unidentified patterns within medical and bibeen disrupting and changing many industries, including ological data that can inform individualized disease preveninformation access, communication, retail, manufacturing, tion and care. It can also be used for biomedical discovery. agriculture, entertainment, travel, finance, and education, For many clinical tasks, AI can often outperform – in its seismic tremor is just beginning to impact the largest speed and accuracy – trained clinicians. Here, I am providing industry in the U.S., which accounts for nearly one-fifth of its only a few examples from a rapidly expanding list of medical GDP: health care. AI applications. AI systems developed by training with The AI revolution promises to be an exciting era. With massive numbers of images can recognize melanoma from virtually unlimited potential, medical AI is rapidly evolving photographs of the skin; diabetic retinopathy and glaucoma to produce ever greater numbers of increasingly advanced can be diagnosed by AI from OCT images; and endovascular clinical applications that will dramatically improve patient thrombectomy eligibility can be determined by AI using the care, disease prevention and biomedical discovery. CT scans of stroke patients. However, no clinical research or improvements in mediAI systems developed from human behavioral data can cine will do more to accelerate the adoption of AI like NTAP detect early signs of Parkinson’s from typing movement will. This pattern of adoption after payments programs for of the hands; depression can be determined from sleep Computer Aided Diagnostics (CAD) for mammography is patterns tracked by mobile devices; and fall risks can be well understood and documented in research literature. predicted through gait analysis videos. AI systems develIt cannot just be good medicine, it has to be profitable oped from longitudinal electronic health records (EHR) can too. • predict a multitude of health conditions such as myocardial infarction, heart failure, sepsis onset and stroke. It can also MARK A. WATTS is the enterprise imaging director at Fountain assist in the analysis of critical quality and safety issues that Hills Medical Center. include ICU mortality and hospital readmission. In addition, WWW.THEICECOMMUNITY.COM
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INSIGHTS
THE ROMAN REVIEW BY MANNY ROMAN, CRES
THE ADD-ONS I
n a previous life, I conducted a short session covering defensive win-win negotiations. I discussed tactics that your “adversary” could and would use against you. Then, I would discuss the counters to these tactics and the counters to the counters. All of this stuff can easily be found on the Internet now and in many great books. As I mentioned, I did this quite a while ago and although I believe that we are always negotiating, I have exiled most of this stuff to a short area of long-term memory. I am no longer consciously prepared to recognize and respond to all the tactics and maneuvers that are being employed to my disadvantage. Only when I perceive harm do I recollect appropriate counters, otherwise I happily comply without much thought. Until recently. I became aware that one specific and very effective tactic has been implemented beautifully on me for quite some time. A well-implemented add-on is almost imperceptible as a tactic and compliance seems like a natural progression of the situation. Let me provide an example. A long time ago I had a boat called StuckIn that I needed to sell. StuckIn had proven to be a real problem since I was 46
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always getting stuck in the shallows, in the weeds and even while trailering it through a drive-through restaurant. I found a willing buyer and we negotiated a reasonable price. He filled out the check, including the signature line and halted in deep thought at the amount line. He looked at me and said, “It does have a full tank of gas, correct?” I did not know what to do. The check was almost completed and the tank was almost depleted. He got another fifty dollars from me. This is the “after the handshake add-on” implemented beautifully. Another add-on is the “after the contract” when they add insurance, extended warranties, detailing, etc. to a car you just bought. You are exhausted and happy from the test drive and all the negotiation tactics that are used and then this all comes up. How can you not give in for just a few bucks more? Add-ons are especially effective after a series of agreements are reached. You have become accustomed to saying “Yes” to a series of reasonable and non-threatening requests. This is how the add-on tactic is being used on me. And the culprit is my loving wife, Ruth. She will begin the process with something like an invitation to get lunch at a favorite restaurant. I agree and we get in the car. As we pull out of the garage, she will inform me that we need to stop at the post office. I agree and as we approach the ADVANCING THE IMAGING PROFESSIONAL
post office, she informs me that we are in need of a quick stop at the grocery store for eggs and milk. I agree and as we enter the grocery store, she reveals the list of 200 items we need to purchase today before lunch. The plan was always to get me to the grocery store. By making it an add-on I have little choice but to continue to agree. In a real negotiation situation the counter would be to predict in advance what the add-ons will be and prepare to deal with them. I should have anticipated the possibility of the
full tank question and replied that he just negotiated a great price on a boat with an awesome name. He should not also expect me to fill the tank and if he wishes to revisit the negotiations, we can do that. It is advisable to retain walk-away power. That means to know when the negotiation has reached a point at which you will walk away. Know yours and theirs as well. I am now reacquainted with the fact that we are always negotiating – even for small things. We are always engaged in a give and take situation
which we wish to be a win-win outcome. We need to be aware of the tactics that will be implemented and how to counter them in order to achieve the win-win. Add-ons are just some of the tactics. Research the others. The consequence of a win-lose may be resentment and animosity by the loser. I now find it fun to conduct the sparring contest that results from the negotiation for the real and final addon that Ruth desires. She, of course, disagrees that it is fun even though, in the end, she wins.
X-R AY T UBES & P ARTS FOR M EDICAL I MAGING E QUIPMENT
X-Ray Tubes for CT, Cath/Angio, and X-Ray
• Tubes for All Major Equipment Brands • New, Used, and Refurbished • OEM Replacement Parts Email: sales@w7global.com Toll Free: 855-W7GLOBA (974-5622)
Online: www.w7global.com WWW.THEICECOMMUNITY.COM
ICEMAGAZINE
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AMSP
SPONSORED CONTENT
AMSP MEMBER DIRECTORY I M A G I N G Brandywine Imaging, Inc. www.brandywineimaging.com 800-541-0632
Interstate Imaging www.interstateimaging.com 800-421-2402
King's Medical Group www.kingsmedical.com 612-757-6714
Medlink Imaging www.medlinkimaging.com 800-456-7800
Preferred Diagnostic Equipment Service, Inc. www.pdiagnostic.net 951-340-0760
Radon Medical Imaging www.radonmedicalimaging.com 800-722-1991
The Association of Medical Service Providers (AMSP) is the premier national association of independent service and products providers to the health care technology industry. Our large pool of modality specialists provide for lower costs and higher quality services for our customers throughout the U.S. Learn more at www.amsp.net.
48
ICEMAGAZINE | AUGUST 2021
ADVANCING THE IMAGING PROFESSIONAL
“To succeed in baseball, as in life, you must make adjustments.” – Ken Griffey, Jr.
SCIENCE MATTERS
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9 5
3
1 4
1
1 5 3 2 8 6 1 7 3 6
1
[QUOTE OF THE MONTH]
ICE Break
4
2 6 3 9
4
9 6
Puzzle by websudoku.com
Solution at the icecommunity.com/sudoku
ICEMAGAZINE
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INDEX
ADVERTISER INDEX ICE Webinars p. 27 AllParts Medical p. 38
Metropolis International p. 37
Injector Support and Service p. 18 Association of Medical Service Providers (AMSP) p. 48
PM Imaging Management p. 37 Innovatus Imaging Back Cover
Beekley Medical p. 41 KEI Medical Imaging p. 41
Banner Imaging p. 3
Renovo Solutions p. 25
SOLUTIONS
King's Medical Group p. 23
TriImaging Solutions p. 15
Carestream p. 2 MRIequip p. 4
Diagnostic Solutions p. 43
MedWrench p. 50
UMAC p. 9
W7 Global LLC p. 47
HTMjobs.com p. 44 WWW.THEICECOMMUNITY.COM
MW Imaging Corp. p. 5
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WORKING AT THE SPEED OF LIFE H
ospital staff moves at the speed of life, across all areas of healthcare, racing patients to the technology, services, and care they need. Yet when critical diagnostic products are not operating at peak performance, the race for help, healing, or life can hit a brick wall.
At Innovatus Imaging, we know how critical speed is to keeping your imaging devices up and running. It's why we've invested millions in improving infrastructure and staff, accelerating our training programs, increasing efficiencies, and developing proprietary processes that get the most popular models of MRI coils and ultrasound probes into our Centers of Excellence and back to your technologists and patients faster than ever before. We call it RapidRepair. You can call it Life. To arrange for a loaner or setup your RapidRepair contact us today at 844-687-5100 or customercare@innovatusimaging.com.
| CONTACT US |
www.innovatusimaging.com Call us at 844-687-5100 Pittsburgh | Tulsa | Denver