ICE Magazine October 2022

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OCTOBER 2022 | VOLUME 6 | ISSUE 10 MAGAZINE ADVANCING IMAGING PROFESSIONALS THEICECOMMUNITY.COM NO MAKING UP FOR LOST TIME Impacts of the Pandemic Lapse in Breast Cancer Screening PAGE 36 PRODUCT FOCUS WOMEN’S IMAGING PAGE 32
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FEATURES

42

DIRECTOR’S CUT

Often a successful screening mammography program is the beacon of light for an imaging practice. For many it is an opportunity to make an outstanding first impression.

36

COVER STORY

Bringing at-risk and underserved patients in for routine breast cancer screening can be a complex proposition. The COVID-19 pandemic provided additional challenges for many.

14

RISING STAR

Rayssa Salinas, RT(R)(CT) ARRT, is an imaging technical supervisor at the University of Texas Medical Branch (UTMB).

ADVANCING THE IMAGING PROFESSIONAL6 ICEMAGAZINE | OCTOBER 2022

IMAGING NEWS

Catch up on the latest news from around the diagnostic imaging world.

2032

PRODUCT FOCUS

ICE spotlights women’s imaging devices available in the United States.

EMOTIONAL INTELLIGENCE

It is not uncommon for some training programs to provide an ROI of more than 900%. The problem is that “Training ROI” is seldom a line item in a budget.

OCTOBER 2022
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CONTENTS

Publishing

Tyrone

President

M. Krieg

President

Kristin Leavoy

Group Publisher

Megan Strand

Account Executives

Jayme McKelvey

Emily Hise

John Wallace

Department

Karlee Gower

Taylor Powers

Kameryn Johnson

Kristin Leavoy

Linda Hasluem

Department

Cindy Galindo

Kennedy Krieg

Diane Costea

Board

Manny Roman Christopher Nowak

Jef Williams

Laberee

Jason Theadore

Walton-Trujillo

SPOTLIGHT

10 In Focus Michelle Dossa, PhD, RT(R) 12 Rad Idea Staffing Struggles Are Real 14 Rising Star Rayssa Salinas, RT(R)(CT) ARRT 16 Off the Clock Wendy Renneke, RT (R) (CT) NEWS 20 Imaging News A Look at What’s Changing in the Imaging Industry PRODUCTS 31 Market Report 32 Product Focus Women’s Imaging INSIGHTS 40 SPONSORED: Banner Imaging From Health Care Administrator to Imaging Patient: A journey through perspective 42 Director’s Cut First Impression Can Create Lasting Image 44 PACS/IT A Code of Ethics for Artificial Intelligence and Imaging 46 Chew On This Managing Medical Errors, Using AI and Industry Learnings 48 Emotional Intelligence Now Is Not The Time To Cut Training 50 ICE Break 51 Roman Review Tasking: Multi and Switch 52 AMSP Member Directory 53 AMSP Profile Radon Medical Imaging 54 Index ICE Magazine (Vol. 6, Issue #10) October 2022 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. © 2022 MD
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MICHELLE DOSSA

FOCUS IN

michelle Dossa, Ph.D., RT(R), serves as University Hospitals of Cleveland’s radiology director, west market. Her career journey, like that of many of her peers, followed a discovery that married her interests of patient care and technology.

Dossa explained that she at tended Ohio State University fo cused on moving on to medical school to become a physician. Her plans changed because “organic chemistry lab and I did not get along.”

“I started to explore allied health fields and found the rad tech program there. I found the mix of patient care and technol ogy very interesting. Over time, I completed my master’s in man agement and my Ph.D. in organi zational leadership,” she said.

Dossa lists earning a Ph.D. in organizational leadership as her greatest accomplishment. She

explained that it took six and a half years of very little sleep and lots of learning. In the end, she said that it was “incredi bly challenging and worth the sleepless nights.”

Her career choice also ranks among her top decisions. Dossa said she loves her job because, “I am so fortunate to work with amazing people who band to gether to provide great care for our patients and each other. My work family is the best. My cur rent role has given me a great opportunity to learn, support the team I lead and make posi tive change in our organization.”

“Leadership is all about building relationships, setting expectations and understanding what motivates each person to perform at the highest level,” Dossa added. “It requires taking time to get to know your team and each person’s talents/as pirations. Once you know that, you can find opportunities for

SPOTLIGHT
Michelle Dossa, Ph.D., RT(R), is an imaging leader at University Hospitals of Cleveland.
10 ICEMAGAZINE | OCTOBER 2022

the team to shine and grow.”

Her position also gives her a unique perspective to view an exciting and challenging time in diagnostic imaging

“I’m excited to see how artificial and augmented intelligence impacts imaging. And, given the demand ing business environment we are in, how imaging reacts/responds to those challenges – how we address staffing shortages, recruitment/retention, employee satisfaction,” Dossa said.

She sees a need for creative and positive leadership to navigate the challenges.

Leadership styles vary and Dossa leans on her expe riences as a high school athlete.

“I played sports growing up – tennis and volleyball. My high school volleyball coach, in particular, was a great mentor. He taught me how to work with oth ers as a team – each member playing their position, focus on fundamentals. I was the setter so anyone who knows volleyball knows you set others up for their big hits. That translates to my work as a leader today –you need to set your team up for their big hits,” Dossa said. “He also taught us how to win and lose together. Resilience when you lose and good sportsmanship when you win.”

Her parents also played a vital role in shaping her

MICHELLE DOSSA

PhD, RT(R), Radiology Director, West Market

1. What is the last book you read? Or, what book are you reading currently? Just finished Colin Powell’s, “It Worked for Me In Life and Leadership” – great book! He shared leadership lessons he learned throughout his military and public service careers. “Take care of the troops” resonated – it is all about our people. We need to care for them and build them to be their best and they will never disappoint.

2. Favorite movie? “Goodfellas”

3. What is something most of your coworkers don’t know about you? Not sure if they know or not, but in college I lived on an island for two summers working OSU residence and dining halls – Gibraltar Island in Lake Erie. Ohio State has a biological field station there called Stone Lab. Two very fun summers many, many years ago.

4. Who is your mentor? I’ve been fortunate to have many mentors – my parents, high school coaches, my Ph.D. chair, leaders I have worked for. Our new leadership team – vice presidents, directors and our chairs. There is something to learn from everyone we encounter.

5. What is one thing you do every morning to start your day? Always get up on the first try and never hit the snooze button.

leadership style. She said that lessons about hard work and expecting a lot out of herself and others helped shaped who she is today.

“They taught me the importance of setting goals and working toward them. The importance of caring for those around you, volunteering your time and do ing what is right when no one is watching,” she added.

She credits all of her mentors with teaching her the importance of humility.

“Be humble,” is a lesson she said she learned. “You do not know everything and need to have a strong team around you with many different talents. The mo ment you think you have this leadership thing all sewn up – that is when the bus comes and runs you over.”

Looking back, Dossa said diagnostic imaging was the perfect choice for her when she shifted her focus as an undergraduate student.

“Having been in imaging for 30 years, and in lead ership for 20 of those years, I have no regrets. Imaging is an incredibly rewarding profession and I have been so blessed to meet many wonderful technologists, ra diologists, nurses, etcetera throughout my career,” she said. “The best days are when you hear from a patient saying how great the care received was and you can recognize team members for that care.” •

6. Best advice you ever received? First words my Ph.D. chair ever said to me. “I’m not interested in your uninformed opinion.” He wanted me to do my homework/research on a topic before speaking. Bring your ideas forward with supporting documentation. That advice has served me well.

7. Who has had the biggest influence on your life? My parents – they worked hard and supported me in whatever I wanted to do; valued education, honesty, and hard work. I am grateful to them every day for instilling those values in me.

8. What would your superpower be? The ability to stop time –have infinite amount of time to do everything I want to do.

9. What are your hobbies? Love being outdoors – Cleveland has great metroparks. Ohio State football of course (Go Bucks!) and always rooting for the Cleveland sports teams. Spending time with family and friends. Travel – especially to places with a lot of history. History – I love reading books about political figures and their leadership.

10. What is your perfect meal? Filet medium rare with sautéed veggies from J Gilberts. One is located in Columbus, Ohio and another in McLean, Virginia. Check them out if you are in the neighborhood.

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Rad idea

STAFFING STRUGGLES ARE REAL

The struggle is real when it comes to attracting and retaining talent. I have attended three professional conferences this year and the near universal sentiment is that there are staffing challenges. My time at the North Carolina Society of Radiologic Technologist Inc., ASRT Educational Symposium, the ASRT Annual Governance and House of Delegates Meeting and the AHRA’s Annual Meeting all had testimony from leaders about the impact being felt. There are many reasons and justifications as to why this is, such as burnout, retirement of senior technologists, travel positions offering more money, better opportunities and the list goes on. Instead of focusing on the individual causes perhaps changes wil solve this problem.

OUTREACH AND AWARENESS

Outreach and awareness are two areas that can provide a way forward for our profession. I am a believer of making face-to-face contact with soon to be graduating imaging students. I have employed this strategy at every opportunity. A class is getting ready to graduate, I am sending emails and making phone calls requesting an audience with the class itself. The outreach strategy is to bring a small team from the organization and present the opportunities available to the class. The team consisted of a human resource recruitment specialist, the administrative director of radiology and me (director of radiology). This allowed us to cover many topics that the students were curious about. Resume, interview, benefits and continuing education questions were just some of the topics covered. The awareness strategy is similar. The main difference is I am there to provide general answers to questions they have and am not actively recruiting. I believe in the awareness strategy as it is beneficial to have a volun teer spend time to answer questions. Questions presented included how to negotiate for salary, importance of and how to prepare for interviews, expectations for new hires and introduction of professional societies that enriched their craft and career field.

BACK TO THE BASICS!

In the military, Army units are encouraged to sponsor schools in the surrounding area. Typical support provided

by these units include school supplies and coat donations, along with reading books to students. This served a couple of purposes. The first purpose is building support among the community. The second purpose is indirect recruitment, having our military members around in uniform could lead to kids deciding to join the military when they are older. In a military hospital where I served previously, we would host high school students to volunteer, job shadow and/or be exposed to the numerous departments within the hospital. When local high schools hosted job fairs, we would present the different jobs available via the military. This approach can easily be transferred to hospitals and departments to establish relationships within the community. I asked one recent radiology technologist how she became aware of medical imaging, her answer (in summary) was “by acci dent.” A renewed effort by medical imaging professionals to invest time with local high schools is an opportunity we can capitalize on.

BUT WHAT ABOUT NOW?

I hear the groans in the room, but “Tomio the ideas men tioned above don’t help me out now.” I say, “You are cor rect. The return of investment on the previous ideas ranges from several months to years.” Then, a possible and highly controversial suggestion would be to look at an intern technologist and or early graduate program. For example, hiring a second-year student from a two-year program may be a solution for you. The pros of this are numerous and begin with being able to augment your workload by using this process. They can assist with performing exams under predefined conditions that are approved by the organization, department and fair for the student. Perhaps, that idea is too radical. So, why not hire them as a transport, tech aid and/ or radiology medical assistant? The idea is to offer them em ployment before they graduate with direct access to full-time employment upon graduation and attaining the appropriate certification. The goal is to expose, inform and develop the student to speed up the transition from student to technolo gist. The benefit for the student is knowing the organization is willing to support and invest in their future.

- Tomio Calhoun is the director of radiology at Sampson Regional Medical Center.

SPOTLIGHT
Share your RAD IDEA via an email to editor@mdpublishing.com.
ADVANCING THE IMAGING PROFESSIONAL12 ICEMAGAZINE | OCTOBER 2022

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STAR RISING

RAYSSA SALINAS, RT(R)(CT) ARRT

Rayssa Salinas, RT(R)(CT) ARRT, holds a Bachelor of Science in Radiography Education and Management and is the imaging technical supervisor at the University of Texas Medical Branch (UTMB). ICE recently learned more about this rising star via a question-and-answer session.

Q: WHERE DID YOU GROW UP?

A: I was born in Los Angles, California, but I moved to Galveston, Texas with my family at the age of 13 and have lived in Galveston County since.

Q: WHERE DID YOU RECEIVE YOUR IMAGING TRAINING/ EDUCATION?

Rayssa Salinas, RT(R)(CT) ARRT, is a rising star at the University of Texas Medical Branch.

A: I began my training at Galveston College where I re ceived my associate degree in radiography. I continued on to complete the computed tomography program after working in X-ray for a year. I received my Bachelor of Science from the University of Texas MD Anderson with a focus in radiography education and leadership. I am now currently working towards my Master of Management and Leadership from Western Governors University and hope to complete the program by June 2023. I hold two certifica tions through the American Registry of Radiologic Technol ogists (ARRT) in radiography and computed tomography.

SPOTLIGHT
ADVANCING THE IMAGING PROFESSIONAL14 ICEMAGAZINE | OCTOBER 2022

Q: HOW DID YOU FIRST DECIDE TO START WORKING IN IMAGING?

A: I can honestly say I just think it was meant to be. I was a business major at the Texas State University, and I knew I was not in the right field. I decided to cut my losses and move back home to Galveston, Texas. I want ed a career that I could feel passionate about but had no idea what direction to go in. I heard Galveston Col lege had a great school for health professions. I decided to apply to the radiography program thinking it could be an interesting career. I had no idea how large the ra diology scope was and immediately fell in love with the profession once I started my program.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD?

A: I was lucky. I was looking for a new path after de ciding that being a business major was not for me. I applied to the radiography program to give it a shot. I never would have expected to end up in the medical field, but I am happy I did. This field has given me a career I love, and that I am passionate about. I love what we contribute to patient care. Imaging has changed pa tient care and is truly valuable for correctly diagnosing and treating a patient.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

A: I recently took on a new role as the imaging supervi sor at UTMB. I love that I never have the same day twice. I am never stuck at a desk, and I am always learning something new. In my new position, I have the oppor tunity to combine my leadership skills with my passion for education. I will be in charge of the cross-training program our hospital offers and contribute to the next generation of technologists entering the field.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD?

A: I love CT. Its capabilities are fascinating to me. I love seeing the technology evolve and improve over the years. I think it is so important to know your equip ment’s capabilities and to know your pathology and protocols in order to optimize patient care. You never want to see pathology on your patients scan, but having the ability to identify it and notify the physician quicky can save someone’s life. Knowing you contributed to a patient’s successful outcome is a feeling that sticks with you and is one of my favorite parts of the field.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR?

A: I can honestly say my greatest accomplishment has been seeing students and new technologist that I have taught, trained or mentored develop into exceptional technologist.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS?

A: Over the next 5 years I would love to finish my master’s degree, find success in my current role and grow my career in education. I would also love to be published one day soon. •

FUN FACTS

FAVORITE HOBBY: Honestly, I am simple. I just love walking my pups, enjoying nature and traveling.

FAVORITE SHOW: “Friends” … I have seen every episode 100 times and I still laugh when I watch it.

FAVORITE FOOD: A Cuban dish called “Vaca Frita”

FAVORITE VACATION SPOT: I love nature, so far Alaska and Costa Rica have really wowed me!

ONE THING ON YOUR BUCKET

LIST: I want to visit Galapagos Islands and experience their unique wildlife.

SOMETHING YOUR CO-WORKERS

DON’T KNOW ABOUT YOU: Before radiography I worked as a bartender for many years and can still do some of my old bar tricks!

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Clock Off THE WENDY RENNEKE, RT(R)(CT)

For the past 30 years, Wendy Renneke of Woodinville, Washington, has worked for the University of Washington Medical Center. Her imaging expertise led her from roles as a radiologic technologist into imaging supervisory positions and, finally, to her current job as practice manager for an outpatient primary care clinic in the UW Medicine health system.

And throughout her career, Renneke hasn’t only been pulling her weight in the office – she’s been moving it at the gym, too. A high-school athlete in track and field, Renneke has always prioritized physical activity, and never lost her sense of com petitive spirit.

At the age of 48, her local fitness center, Progressive Per formance, held a promotional contest inviting guests to find their “why” for working out. Renneke became connected with coach Jimmy McCurry, who took her from “maybe I’ll give this a shot” to “why don’t you think about competing?”

“You go through the evolution of what fits in your life,” she said. “I used to be a runner, and then I hurt my knee and couldn’t. I used to ride my bike to work 23 miles, there and back, and it clears your head. I wasn’t sure that I could get back into lifting with various injuries to my body. But you have to find what fits, and it all just tastes good again.”

Renneke suddenly found herself tracking macros, setting body composition goals, and diving back into a full-time fitness regimen. As her progress continued to mount, so did her ambitions. Renneke fixed her gaze on the state master’s deadlift record for women in her age group.

“What’s enjoyable about lifting weights is that it’s you, and iron, and gravity,” she said. “You leave your work behind when

you go to the gym, and you leave the gym behind when you go to work. It is just you against whatever your own personal goals are.”

“I started training really hard, and eventually set a goal to hopefully set the Washington State women’s master’s deadlift record,” Renneke said, “and in 2019, I accomplished that goal –374.8 pounds. There’s some young people who lift a lot heavier than that, but it still stands.”

Renneke continued lifting more casually after she hit her mark, but after the novel coronavirus (COVID-19) pandem ic struck, her four or five days in the gym fell to zero. After battling the virus herself, rediscovering her exercise routine has been a challenge. But after “getting outed” as a weightlifter in a group icebreaker at an AHRA meeting, Renneke said she’s begun to reconsider what’s behind her struggles.

“I have an entire gym in my basement,” she said: “a squat rack and a bench and some universal equipment and a rowing machine and an elliptical. It stares at me every day.”

“I think it is this hurdle that you have to get over,” Renneke said. “Our days stop us from getting over the hurdle because there’s so many other responsibilities. You’re mentally and physically exhausted when you get home. Initially, it’s difficult to tell yourself you will feel better in the end if you just make the effort to begin, and then it starts to take shape. You feel better the more effort you give, and eventually you get to the point you feel horrible when you don’t uphold your commit ment to yourself to work out.”

At 52, Renneke is also cognizant of how changes in her bio chemistry – in bone density, strength, and muscle mass – all are related to remaining in good health as she ages. Aside from the physical benefits, she knows there’s a positive emotional payoff with exercise that is also rewarding. And as she fights to recapture the feelings of how a good fitness routine fuels the other aspects of her mental and physical well-being, Renneke

SPOTLIGHT ADVANCING THE IMAGING PROFESSIONAL16 ICEMAGAZINE | OCTOBER 2022

is learning how to redefine those goals that led her to the podium at that mas ter’s meet four years ago.

“When you find that niche that’s work ing for you, no matter what it is, every other part of your life benefits from you being healthy because of that pursuit,” she said. “I am in the process of making myself believe that I know what the other side feels like; making the time to make it not a choice, but a practice. It has to be a routine or else it won’t take form, and it won’t take hold.”

“You have to get a taste of it so you know you want to do it,” she said. “The pivotal moment is when you decide to make yourself a priority. When you realize how many other things benefit from that – your kids, your work, your clarity of mind – that’s it.”

Renneke and her husband, Troy, are parents to five children aged 14 to 24, and when she’s not at work or work ing out, enjoys spending time in the outdoors. The couple hunts and fishes together in the Washington wilderness;

indoors, Wendy follows her passion for creative pursuits, from painting to photography. She also keeps a low-key eye out to see if her master’s record still stands (it does). She’s still motivated by the thought of new achievements.

“There are other goals,” Renneke said. “I’m a couple years older, and in a new master’s event. It’s all relative; it’s just got to mean something to me.”

“I think that is the biggest lesson that I learned from it,” she said. “You go to the gym, you start working out, someone identifies a natural talent that you have, and they give their time to help you craft that into something. In order to do that, you have to dedicate yourself to it. You have to make yourself a priority.” •

Wendy Renneke set the Washington State women’s master’s deadlift record in 2019. When not working or working out, she enjoys the outdoors and art.
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Imaging News

A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

PRESTIGE MEDICAL IMAGING ACQUIRES XRV HEALTHCARE, MEDSERV PLUS

Prestige Medical Imaging (PMI) has completed acquisitions of XRV Healthcare and MedServ Plus.

A news release states that the additions of XRV Health care and MedServ Plus to the PMI business platform bring together three of the most prominent dealers in the medical imaging industry, solidifying the combined entity as the larg est independent radiology service and solutions provider in the Eastern United States.

“We couldn’t be happier to have two incredible orga nizations in XRV Healthcare and MedServ Plus joining the PMI family,” said Bill Haussmann, chief executive officer of Prestige Medical Imaging. “Our three companies present seamless fits both operationally and culturally, so we’re really excited for our employees and for our customers. The future is now for PMI.”

“XRV Healthcare, a 20-year industry stalwart from Springfield, Virginia, bridges PMI’s comprehensive customer coverage area between the Northeast and Southeast. XRV Healthcare, like MedServ Plus, complements PMI’s existing sales and service organizations in a previously underdevel oped geographic segment,” the release states.

“We’ve long respected PMI and MedServ as leaders in the industry. To now be one organization with them is truly exciting for everyone here at XRV Healthcare,” XRV Health care CEO Bud Mori said.

MedServ Plus — with offices in Beaver Falls, Pennsylvania, and East Palestine, Ohio — bolsters PMI’s industry strong hold in the Great Lakes region with 19 years of expertise, according to the release.

MedServ Plus services and sells a broad suite of equip ment modalities within PMI’s existing customer segments.

“We can’t wait to hit the ground running with PMI. It has always been important for us to retain our family values as we grow as an organization, and we’re doing just that in joining PMI. I’m looking forward to taking our companies to the next level of growth together,” MedServ Plus President Craig McCowin said.

Prestige Medical Imaging and partner Atlantic Street Capital are actively seeking additional acquisitions to broaden PMI’s geographic footprint and enhance its suite of product offerings, according to the release.

In other news, PMI has agreed to a multi-year partnership extension with the Miami Heat of the National Basketball Association (NBA). As the “Official X-Ray Provider of the Miami Heat” PMI installed cutting-edge medical imaging equipment at FTX Arena in Miami and will provide the Heat with industry-leading service and support for its equipment, according to a press release.

NEWS
ADVANCING THE IMAGING PROFESSIONAL20 ICEMAGAZINE | OCTOBER 2022

REPORT: BEST PRACTICES FOR HANDLING BIAS IN RADIOLOGY AI

With the increasing use of artificial intelligence (AI) in radiology, it is critical to minimize bias within ma chine learning systems before implementing their use in real-world clinical scenarios, according to a special report published in the journal Radiology: Artificial Intelligence , a journal of the Radiological Society of North America (RSNA).

The report, the first in a three-part series, outlines the suboptimal practices used in the data handling phase of machine learning system development and presents strategies to mitigate them.

“There are 12 suboptimal practices that happen during the data handling phase of developing a machine learning system, each of which can predis pose the system to bias,” said Bradley J. Erickson, M.D., Ph.D., professor of radiology and director of the AI Lab at the Mayo Clinic, in Rochester, Minnesota. “If these systematic biases are unrecognized or not accurately quantified, suboptimal results will ensue, limiting the application of AI to real-world scenarios.”

Erickson said the topic of proper data handling is gaining more attention, yet guidelines on the correct management of big data are scarce.

“Regulatory challenges and translational gaps still hinder the implementation of machine learning in real-world clinical scenarios. However, we expect the exponential growth in radiology AI systems to accel erate the removal of these barriers,” Erickson said. “To prepare machine learning systems for adoption and clinical implementation, it’s critical that we mini mize bias.”

Within the report, Erickson and his team suggest mitigation strategies for the 12 suboptimal practic es that occur within the four data handling steps of machine learning system development (three for each data handling step), including:

• Data collection — improper identification of the data set, single source of data, unreliable source of data

• Data investigation — inadequate exploratory data analysis, exploratory data analysis with no do main expertise, failing to observe actual data

• Data splitting — leakage between data sets, unrep

resentative data sets, overfitting to hyperparameters

• Data engineering — improper feature removal, improper feature rescaling, mismanagement of missing data

Erickson said medical data is often far from ideally suited as input for machine learning algorithms.

“Each of these steps could be prone to systematic or random biases,” he said. “It’s the responsibility of developers to accurately handle data in challenging scenarios like data sampling, de-identification, anno tation, labeling, and managing missing values.”

According to the report, careful planning before data collection should include an in-depth review of clinical and technical literature and collaboration with data science expertise.

“Multidisciplinary machine learning teams should have members or leaders with both data science and domain (clinical) expertise,” he said.

To develop a more heterogeneous training dataset, Erickson and his coauthors suggest collecting data from multiple institutions from different geographical locations, using data from different vendors and from different times, or including public datasets.

“Creating a robust machine learning system re quires researchers to do detective work and look for ways in which the data may be fooling you,” he said. “Before you put data into the training module, you must analyze it to ensure it’s reflective of your target population. AI won’t do it for you.”

Erickson said that even after excellent data han dling, machine learning systems can still be prone to significant biases. The second and third reports in the Radiology: Artificial Intelligenc e series focus on bias es that occur in the model development and model evaluation and reporting phases.

“In recent years, machine learning has demon strated its utility in many clinical research areas, from reconstructing images and hypothesis testing to im proving diagnostic, prognostic and monitoring tools,” Erickson said. “This series of reports aims to identify erroneous practices during machine learning devel opment and mitigate as many of them as possible.”

ICEMAGAZINE 21WWW.THEICECOMMUNITY.COM

NEW FIXED X-RAY SYSTEM BRINGS ‘PERSONAL ASSISTANT’ TO RADIOLOGY DEPARTMENTS

GE Healthcare recently released its most advanced fixed X-ray system yet, the next-generation Definium 656 HD. Leading GE Healthcare’s portfolio of fixed X-ray products, this latest generation of the overhead tube suspension (OTS) system delivers consistent, highly automated, efficient exams that impart clinical confidence while simplifying workflow, improving consistency, and reducing errors to help keep radiology departments running smoothly.

The Definium 656 HD, featuring the Intelligent Workflow Suite, is a versatile, digital radiographic system powered by GE’s FlashPad HD high resolution detectors and the latest Helix 2.2 advanced image processing software. Combining the highest levels of motorization, automation, assistive in telligence and advanced applications with fastest movement and highest weight capacity in GE Healthcare’s fixed X-ray portfolio, the system acts like a “personal assistant” to help technologists deliver consistent, efficient, and highly auto mated imaging exams that impart clinical confidence across the radiology department, while also improving overall patient experience by keeping workflow control in the room for health care providers.

To address the day-to-day physical demands of technol

ogists, the next-generation Definium 656 HD helps reduce patient positioning time, physical workload, errors and image retakes through easy-to-use features that speed up the imaging process without compromising image quality. Its 5-axis motorization and auto-positioning provides for fast automatic positioning to any location in the room to speed up workflow and reduce strain on the technologist. Auto mated in-room workflows enabled by a 12-inch touchscreen on the tube head console, and AutoRad software, support manual or automatic workflow control in the room to reduce the number of steps and clicks for technologists. The Intel ligent Workflow Suite leverages 3D camera technology to produce more consistent images while avoiding repeated X-rays before they occur.

To address “repeat and reject” rates that can nega tively impact day-to-day clinical operations as well as give radiologists the views they need to make clinical decisions with confidence, the Definium 656 HD also features high-quality detectors, advanced applications, and AI-driven image processing to reduce variability and provides optimal image quality.

NEWS ADVANCING THE IMAGING PROFESSIONAL22 ICEMAGAZINE | OCTOBER 2022

PILOT PROGRAM EMPLOYS VR TO HELP PATIENTS

RELAX, REDUCE ANXIETY

Rocket VR Health, a digital therapeutics company develop ing immersive therapy programs, is partnering with Penn Medicine’s Abramson Cancer Center to explore the use of virtual reality (VR) technology in cancer patients undergoing radiation therapy.

Rocket VR’s immersive meditation program will be administered as part of a feasibility study with 25 patients prior to receiving daily treatments, utilizing the HTC VIVE Flow VR headset. The imagery and sounds experienced are designed to create an immersive environment by making use of mindfulness meditation in nature. This procedural relaxation and distraction solution aims to transform the pre-procedure wait into a calming VR meditation experi ence. Patients will fill out questionnaires before and after their procedures to evaluate their experience, and staff will be assessed on the ability to deploy this technology for patients undergoing radiation therapy.

“We are thrilled to be working with the talented research team at Penn Medicine as well as the HTC Vive Flow, one of the lightest and most ergonomic headsets on the market,” said Nik Vassev, COO and Co-Founder of Rocket VR Health. “Our solution aims to improve the radiation therapy experi ence, which at times can be anxiety-provoking.”

“Our study aims to demonstrate the feasibility and validi ty of delivering VR-enhanced meditation to reduce anticipa tory anxiety experienced by patients undergoing radiation therapy with the goal to help improve patient well-being during what is certainly one of the most stressful times in their lives,” said William Levin, MD, an associate professor in the Department of Radiation Oncology at the Perelman School of Medicine at Penn. “Because radiation therapy is challenging when the patient is anxious and unable to lay still, we hope to gauge how well patients can slow their breathing for a more comfortable experience.”

ICEMAGAZINE 23WWW.THEICECOMMUNITY.COM

XORAN ANNOUNCES FDA 510(K) CLEARANCE FOR TRULY MOBILE FLUOROSCOPY-CT TRON

Xoran Technologies has received FDA 510(k) clearance for TRON — a truly mobile, full-body fluoroscopy, computed tomography (CT) X-ray system.

“When Xoran states that TRON is the ‘One RING to rule them all,’ we truly mean that this compact, mobile, openbore device is poised to revolutionize global initiatives to democratize access to diagnostic imaging,” says Xoran CEO Misha Rakic. “TRON is uniquely suited to provide safe, ultra-high-resolution, low-dose imaging in traditional settings such as the operating room, surgery center and critical care unit where space is limited, and hospital budgets are stretched thin.”

“Its compact size and weight make it truly nimble without any need for bulky motors and batteries,” continues Rakic. “What’s more, because TRON scans take less than a minute, and the system is easy-to-use, it can be further mobilized by

placing it in small vans, lending TRON to low-dose screen ing brought to patients and not the other way around. This means that Xoran’s Vehicle-Based Solutions can be used for community health initiatives and in ambulance and military front-line scenarios.”

Additionally, in July, Xoran announced it had begun work on Phase 2 of its mobile lung grant – the goal of which is to confirm the safety and utility of a future thoracic pointof-care CT system in support of an FDA submission. These research and development efforts for lung CT are supported by a recent grant award from the National Heart, Lung, and Blood Institute (NHLBI) through the National Institutes of Health (NIH).

NEWS ADVANCING THE IMAGING PROFESSIONAL24 ICEMAGAZINE | OCTOBER 2022

MINDRAY LAUNCHES POCUS SYSTEM

Mindray North America recently launched the TE X Ultrasound System. The technology-rich system gives clinicians access to the most robust suite of artificial intelligence (AI)-pow ered Smart Tools available today and is powered by Mindray’s proprietary soft ware-based beamformer Zone Sonog raphy Technology+ (ZST+), according to a nes release. This new product’s design includes a 23.8-inch rotatable, full touchscreen display that supports both landscape and portrait orientation for easy adaptability to any clinical en vironment, and an industry-first wireless transducer that connects to the TE X System or can be used independently with a mobile device.

The portable TE X Ultrasound System offers a full suite of innovative features and AI-powered Smart Tools to help expedite clinical decision-making and achieve reproducibility between exams.

TE X AI-powered Smart Tool high lights include:

• Smart TTQA: A dedicated speckle

tracking algorithm for strain analysis of the ventricles, providing global and free wall longitudinal strain results and additional segmental performance data.

• Smart Echovue: AI-enhanced cardiac plane recognition, guidance, and interac tive feedback for attaining standard echo views.

• Smart Nerve: Automated recognition and enhancement of nerve bundles to help guide procedures and improve patient outcomes.

• Auto EF Plus: Real-time auto tracing of the LV yielding volume data and Simpson’s EF with one-click.

“The TE series ultrasound family contin ues to push the boundaries of point of care ultrasound,” said Wayne Quinn, president of Mindray North America. “The new TE X carries forth the legacy of the TE family and introduces new wireless transducer technology for emergency medicine and critical care. We are excited to share the system with clinicians and welcome the opportunity to exceed their expectations of what is possible with POCUS.”

2D and Tomosynthesis

WorkstationOne

Perfection in Digital Mammography Viewing Software

kstationOne

Single-click wor kflow Exper t tools

2D and

Single-click

WorkstationOne™ is a software solution for radiologists reading breast imaging modalities. The system pro vides a built-in workflow to aide efficient reading and includes expert tools such as systematic masking and all-pixels viewing as part of the workflow.

Plugins for 3D ultr asound, r epor ting, modalities

kflow

exter-

WorkstationOne™ is a software solution for radiologists reading breast imaging modalities. The system provides a built in workflow to aide efficient reading and includes expert tools such as systematic masking and all pixels viewing as part of the workflow. The user can easily modify the workflow using a visual UI. WorkstationOne operates with any PACS and supports established modalities such as 2D mammography and tomosynthesis and includes newer CAD and decision support display and interaction for 2D and 3D mammography. Plugins are included for related modalities (ultrasound, MRI, documents), along with the ability to generate reports, either stand alone (using an included plugin) or via integration with exter-

LEARN MORE AT:

WorkstationOne™ is a software solution for radiologists reading imaging modalities. The system provides a built in workflow efficient reading includes expert such as systematmasking and all pixels viewing as part of the workflow. The user modify the workflow using a visual UI. WorkstationOne with any PACS and supports established modalities such as mammography and tomosynthesis and includes newer CAD and support display and interaction for 2D and 3D mammograPlugins are included for related modalities (ultrasound, MRI, documents), along with the ability to generate reports, either stand (using an inplugin) or via

Plugins

CAD and d decision suppor t (2D & 3D)

WorkstationOne™ operates with any PACS and sup ports established modalities such as 2D mammography and tomosynthesis and includes CAD/AI display and interaction. Plugins are included for related modalities (such as 2D and 3D ultrasound, MRI, documents).

repor ting, modalities

CAD and decision suppor t (2D & 3D)

Wor ks with any PACS, and inte grates with exter nal wor klist and repor ting systems

Wor ks with any PACS, and inte g r ates with exter nal wor r klist and r epor ting systems

WWW.THEICECOMMUNITY.COM ICEMAGAZINE 25
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CLARIUS MOBILE HEALTH APPOINTS CEO, CIO

Clarius Mobile Health, a provider of high-definition wireless ultrasound systems, announced that Ohad Arazi has been promoted to chief executive officer, succeeding Laurent Pelissier, founder of Clarius, who is taking on the role of chief innovation officer. These leadership changes are the culmination of the leadership succession plan announced in March

and follow market-leading performance in the hand held ultrasound industry in the first half of 2022, according to a press release.

Arazi’s experience spans executive management, strategy and product management roles. He recently served as CEO of Zebra Medical Vision.

Interim Imaging

Just because you don’t have the room or budget to build a full MRI, CT or PET/CT suite does not mean you can’t have those capabilities at your facility. Our Interim Medical Imaging solutions are completely mobile, can be parked and set up just about anywhere, and can remain at your facility for as long as you need them – be it a few days or a few weeks.

Fixed Base Imaging

When you’re ready to show the world you’ve arrived, you’re ready for our Fixed Base Medical Imaging solutions. Whether you need a permanent suite or a modular external structure for MRI, CT or PET/CT capabilities, our full array of turnkey options will have you covered from planning and construction, to equipment purchasing and staffing.

NEWS 763-443-5633 kingsmedical.com contact@kingsmedical.com Every facility has different needs, budgets and patient bases. We’ll work with you to determine what solutions are best for you and your operations.
ADVANCING THE IMAGING PROFESSIONAL26 ICEMAGAZINE | OCTOBER 2022

VASCULAR EXPERTS ESTABLISH APPROPRIATE USE OF IVUS IN PERIPHERAL INTERVENTIONS

Royal Philips has announced an important milestone in the evolving standard of care for treating patients with peripheral vascular disease (PVD): the establishment of the first-ever global consensus for the appropriate use of intravascular ultrasound (IVUS) in lower extremity arterial and venous interventions.

Published in the August 2022 issue of the Journal of the American College of Cardiology: Cardiovascular Inter ventions as “Appropriate Use of Intravascular Ultrasound During Arterial and Venous Lower Extremity Interventions,” the new consensus document from 30 global vascular experts recommends routine use of IVUS as a preferred imaging modality in all phases in many peripheral vascular disease (PVD) procedures.

“The voting panelists considered a variety of clinical scenarios and based on their extensive experience, arrived at a strong consensus,” said lead author Eric A. Secemsky, MD, interventional cardiologist at Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School. “They recommend routine use of IVUS as a preferred imaging modality in all phases for many peripheral interventions, both diagnostic and therapeutic, as it enables such exquisite visualization of the target vessel and lesion. Their recommendations, which withstood the rigor of peer review, can now be considered in the formula

tion of clinical guidelines for the diagnosis and treatment of peripheral vascular disease.”

PVD affects an estimated 200 million people world wide, including approximately 40 to 45 million Americans, according to the American Heart Association. The authors noted that minimally invasive approaches for PVD inter ventions are increasingly common, but traditional imaging techniques like angiography have limitations, including 2-di mensional projections of 3-dimensional vasculature, which can complicate diagnosis and intraprocedural optimization.

“As the global leader in providing vascular solutions to physicians and the patients they serve, we especially value the rigor and independence of this cross-specialty expert consensus,” said Heather Hudnut Page, general manager and business leader for peripheral vascular image guided therapy devices at Philips. “It is exciting to know that this initiative has the potential to standardize the use of IVUS in peripheral interventions and guide clinical decisions to further improve the quality-of-care procedures for patients.”

Supported in part by research grants from Philips and Boston Scientific, the study was conducted and analyzed independently by Smith Center for Outcomes Research, gathering a wide spectrum of vascular expert opinion to ascertain the role of intravascular imaging in contemporary clinical practice.

WWW.THEICECOMMUNITY.COM ICEMAGAZINE 27
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Reports Predict Breast Imaging Market Growth Market Report

Asia Pacific breast imaging market.

The breast imaging market is expected to increase at a 7.1% compound annual growth rate (CAGR) from an anticipated $4.3 billion in 2022 to $8.5 billion by 2032, according to a report by Future Market Insights.

Technological improvements, the rising prevalence of breast cancer, the increasing number of screening programs and the increasing number of conferences and symposiums concen trating on spreading awareness about the advantages of early screening and diagnosis are all driving breast imaging market growth along with breast imaging market adoption trends.

The rising breast imaging markets, increasing government and private investments to support the increasing demand for breast imaging and a better reimbursement picture is likely to provide breast imaging market participants with a wide variety of breast imaging market key trends and opportunity pros pects.

As mammography is the standard procedure for screening breast cancer, governments and other health care organiza tions all over the world are taking steps to ensure that women have access to mammography screening. The global demand for breast imaging and mammography is expanding as a result.

There have been a lot of developments in the area that reduce over-diagnosis and improve sensitivity to identify tiny carcinomas. These ongoing improvements in this discipline are projected to boost the global breast imaging market’s mam mography segment.

The development and increased usage of improved mam mography machines with novel technology are fueling breast imaging market trends.

The Asia Pacific area is a prominent revenue generator in the breast imaging market. The rising prevalence of breast can cer, rising health care expenditure, an increase in the number of breast cancer awareness programs and high government spending on breast cancer research studies in several Asia Pacific countries are major factors driving opportunities in the

In the United States, the breast imaging market is esti mated to reach $3.1 billion by 2032, increasing at a CAGR of 6.9% through 2032. The breast imaging market in the United Kingdom is expected to be worth $350.3 million by 2032, with a CAGR of 5.9% through 2032. China’s breast imaging market is expected to reach $613.6 million by 2032, with a CAGR of 6.4% through 2032.

The breast imaging market’s ionizing breast imaging seg ment from the technology category is predicted to develop at a CAGR of 7.0% through 2032.

MarketsandMarkets also predicts growth.

“The breast imaging market is projected to grow from an estimated $3.7 billion in 2020 to $5.4 billion by 2025, at a CAGR of 8.1% during the forecast period,” according to a release.

The MarketsandMarkets report also states, “Based on tech nology, the breast imaging market is segmented into ionizing breast imaging and non-ionizing breast imaging technologies. The non-ionizing breast imaging segment is expected to grow at the highest CAGR during the forecast period.”

“Non-ionizing breast imaging technologies comprise breast ultrasound, breast MRI, automated whole-breast ultrasound (AWBU), breast thermography, electric impedance tomogra phy and optical imaging. The breast ultrasound segment ac counted for the largest share of the non-ionizing breast imag ing technologies market in 2019 whereas the AWBU segment is estimated to witness the second-highest growth rate during the forecast period. The large share of the breast ultrasound segment can be attributed to the lower risk of exposure to radiation and the benefits offered by breast ultrasound such as the ability to detect lesions and the nature of lesions in women with dense breast tissues, the ability to differentiate between a cyst and a solid mass, and the detection of blood flow through vessels,” the release states.

According to Coherent Market Insights, the global breast imaging market is estimated to be valued at approximately $5 billion in 2022 and is expected to exhibit a CAGR of 10.1% from 2022 to 2030.

STAFF REPORT
• PRODUCTS
ICEMAGAZINE 31WWW.THEICECOMMUNITY.COM

Product Focus

WOMEN’S IMAGING

HOLOGIC 3Dimensions Mammography System

Hologic’s 3Dimensions system is designed to provide higher quality 3D images for radiologists, a more comfortable mammography experience for patients with the SmartCurve breast stabilization system1, and enhanced workflow for technologists. The system offers the unrivaled performance of Hologic’s Genius 3D Mammography exam, which is more accurate than conventional 2D mammograms, detecting 20%-65% more invasive breast cancers.2 The 70-micron high resolution 3D data enables more natural looking Intelli gent 2D synthesized images* and workflow advantag es with 3DQuorum technology* – reducing interpreta tion time, patient dose and time under compression.3-6

REFERENCES

licenses

Smith, A. Improving Patient Comfort in Mammography. Hologic WP-00119

Results from Friedewald, SM, et al. “Breast cancer screening using tomo

311.24 (2014): 2499-2507;

with digital mammography.”

multi-site (13), non-randomized, historical control study of 454,000 screening mammograms investigating the initial impact the intro duction of the Hologic Selenia® Dimensions® on screening outcomes. Indi vidual results may vary. The study found an average 41% (95% CI: 20-65%)

that 1.2 (95% CI: 0.8-1.6) additional invasive breast cancers per

screening

found in women receiving combined 2D FFDM

3D™ mammograms acquired with the Hologic 3D Mammography™

women receiving 2D FFDM mammograms

*Disclaimer: Products are listed in no particular order. PRODUCTS
1
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1000
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only.   3. Tech File: TFL-00059   4. Report: CSR-00116   5. Physician Labeling: MAN-06153   6. FDA Submission: P080003/S008. ADVANCING THE IMAGING PROFESSIONAL32 ICEMAGAZINE | OCTOBER 2022

Cristalle 3D

Fujifilm’s ASPIRE Cristalle is engineered with innovative high-sensitivity capture and advanced image processing technologies to produce exceptional image quality for all breast types at gentle dose. Patient experience enhance ments such as its patented Comfort Paddles and new Comfort Comp feature are designed to make mammo grams noticeably more comfortable. The Comfort Comp feature automatically minimizes compression prior to the exposure, and the Comfort Paddle’s soft edges and fourway pivot contours to the individual breast composition to more comfortably apply the right compression. Fujifilm recently received 510(k) clearance for its contrast enhanced digital mammography (CEDM), an emerging modality that combines digital mammography with the administration of intravenous contrast material.

3 2

GE HEALTHCARE Voluson Expert 22

GE Healthcare recently unveiled its most advanced ultrasound yet, the next-generation Voluson Expert 22. This latest addition to GE Healthcare’s award-winning women’s health portfolio utilizes graphic-based beam former technology, which produces higher quality images and offers greater flexibility in imaging functions. Cutting-edge tools powered by artificial intelligence (AI) ensure greater consistency in exams and decreased number of tasks. Custom izable touch panels, color and lighting options provide for a revolutionary user experience. The Voluson Expert 22’s Lyric Architecture unlocks new imaging and processing power to achieve higher resolution, detailed images — and increased independence from body habitus and other difficult scanning con ditions. The Lyric Architecture generates new levels of penetration, resolution, and frame rates to reveal fine anatomy in 2D/3D/4D with ease, and delivers uniformity throughout the image with increased spatial and contrast resolution.

The MAMMOVISTA B.smart reading platform from Sie mens Healthineers accelerates the reading workflow for breast imaging. The intuitive user interface sup ports maximum reading performance across multiple imaging modalities and reduces the number of clicks required for specific tasks. It also increases the image loading speed by up to 75 percent.1 Artificial intelli gence-supported2 workflows highlight breast tissue abnormalities during the reading phase and provide a confidence score. This score indicates the algorithm’s assessment of the probability of cancerous tissue.

1 Data on file

2 AI is an option and available with Transpara powered by FusionAI, ScreenPointMedical.

SIEMENS HEALTHINEERS MAMMOVISTA B.Smart FUJIFILM ASPIRE
Mammography System 4
ICEMAGAZINE 33WWW.THEICECOMMUNITY.COM
Imaging Jobs NOW AVAILABLE htmjobs.com REGISTER FOR FREE AT HTMJOBS.COM Contact us at htmjobs@mdpublishing.com to learn more about our various posting options! Companies like ours have such a difficult time finding qualified candidates for field service roles that it just made sense to publish our opening with HTMJobs. – K. White, HR/Compliance Manager “ ” LOOKING TO FILL A POSITION? Visit htmjobs.com/start-posting/ to post a job. Companies that post with us: MXR Imaging, OSF Healthcare, First Call Parts, Associated Imaging Services, Medical Imaging Solutions, Renovo Solutions, TRIMEDX, Canon Medical Systems, Cal-Ray, Banner Health, Agiliti and many more!

If you are wondering what makes TRIMEDX different, it’s that all of our associates share a common purpose of serving clients, patients, communities, and each other with equal measures of care and performance. Everyone is focused on serving the customer and we do that by collaborating and supporting each other. Every associate matters and makes a difference.

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Associated Imaging Services has been offering nuclear medicine and ultrasound solutions to our customers since 1990. We specialize in the sales and service of new and refurbished nuclear medicine cameras and ultrasound systems throughout Kansas, Oklahoma, Texas, and the surrounding areas.

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Zone Support Specialist

An Imaging Service Engineer (ISE) performs and documents planned maintenance and repair of medical diagnostic imaging equipment and associated systems with under the supervision from service management to perform the required duties. The ISE must demonstrate a working knowledgeof and ability to use the required test equipment and have the electronic and mechanical knowledge and skills.

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Agiliti is a nationwide company of passionate medical equipment management experts who believe every interaction has the power to change a life. Our industry-leading commitment to quality and team of expert technicians helps ensure clinicians have access to patient-ready equipment needed for patient care. Make an impact in healthcare and grow your career with Team Agiliti!

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Provide modality-specific technical service support within a prescribed zone to Customer Engineers (CE) for resolution of complex customer situations. Recommendations and actions should be focused to drive the Zone to technical self reliance. CMSU is an Equal Opportunity Employer and reasonable accommodations will be considered.

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We specialize in an objective, total solution medical imaging technology pro gram that delivers world-class quality of products and services, resulting in greater efficiency and lower cost to our healthcare provider partners, with a strong focus on clinical staff satisfaction and improving patient outcomes.

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MIS provides asset management solutions for hospitals and imaging institutions nationwide. We combine 20 years of service experience with the industry’s most advanced asset-management software, raising the bar in the industry to manage the increasing demands placed on diagnostic operations.With our contract management program, we make everything imaging as simple as possible for you.,

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Field service on medical equipment, installation of x-ray equipment, Diagnostic Imaging field service engineer servicing multi-vendor/multi-modality equipment in hospital and other environments.

Focusing on c-arms, Digital R/F, Digital Mobiles, x-ray systems and digital capture both DR and CR modalities. Growth opportunities to include CT, MRI, Ultrasound, and others.

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Service

First Call Parts has been providing customers with quality replacement imaging parts since 2009. We pride ourselves in developing a top-notch reputation in the imaging industry as delivering the best in diagnostic imaging replacement parts. We specialize in the sale of refurbished/tested and used, Philips, Siemens, and GE in the Cath/Angio, R/F, and RAD modalities.

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Imaging Engineer II Imaging Service Engineer Imaging Field Service Engineer Field Service Engineer Field Service EngineerNuclear Medicine Imaging Field Service Engineer III X-Ray
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NO MAKING UP FOR LOST TIME Impacts of the Pandemic Lapse in Breast Cancer Screening

At the best of times, bringing at-risk and underserved patients in for routine breast cancer screening can be a complex proposition. But during the novel coronavirus (COVID-19) pandemic, when elective imaging procedures were shelved as all of the health care world shifted to battling the virus, a new wrinkle emerged.

A pre- and post-COVID (March 2019 through May 2021) analysis of the U.S. National Mammography Database pub

lished in the Journal of the American College of Radiology (ACR) in August 2022 identified the impact of these shutdown. Screening mammograms were down 37 percent, diagnostic mammograms down 58 percent, breast biopsies down 47 percent, and cancer diagnoses down 49 percent, all as com pared with pre-pandemic levels.

“Although diagnostic mammogram levels returned to near pre-pandem ic levels … screening mammograms, breast biopsies and, most importantly, cancer diagnoses continue to lag,” wrote Dr. Lars Grimm of the ACR Na

tional Mammography Database (NMD) Committee in a summary.

“These findings are likely to have a major impact on future breast cancer outcomes,” Grimm wrote. “The cancer diagnosis deficit that started in the acute phase of the pandemic continues to grow in parallel with lower screening mammog raphy utilization rates. Failure to diagnose smaller, screen-detected cancers will lead to more late-stage cancers in the future. Initial cancer registry data demonstrates a stage shift to later-stage breast cancers, and multiple modeling studies predict a corresponding increase in patient mor

COVER STORY
ADVANCING THE IMAGING PROFESSIONAL36 ICEMAGAZINE | OCTOBER 2022

bidity and mortality.”

As the nation recovers from the myriad impacts of the pandemic, there are specific concerns as to how breast imaging practitioners are handling the specific needs of their patient popula tions, particularly those who face barri ers to accessing routine screenings.

Henry Izawa is president and chief executive officer of FUJIFILM Healthcare Americas Corporation, and executive vice president of business integration at FUJIFILM Healthcare Americas Corporation. Izawa said that its clinical partners report ed that some of their biggest post-pandemic breast imaging challenges have as much to do with roadblocks in staffing as with generating return visits from hard-toreach, at-risk patients.

“There’s a lot of people who are not coming back to work among our clinician partners, especially the techni cians,” Izawa said. “It’s a very big prob lem. I talk to a lot of rural and critical access hospitals, and the CEOs say, ‘My biggest fear is not money; it’s the fact that I can’t get staff.’ A lot of federally qualified health center (FQHC) facil ities want to provide a line of service [like cancer screening], but they worry about staffing, so they don’t bother. Our fear is that if they stop providing services, the [screening] rate is going to go down more and more.”

The FUJIFILM response to shortstaffed practice environments has been to focus on technological solutions that drive volume through efficiency and a consistency in image quality, with the intention of delivering reproducible results independent of staffing chang es. By studying patient callback ratios and monitoring physician practices, the company found that its clinical partners could improve their study outcomes by re-training them to best position patients for their mammograms. Making those technical adjustments to how practitioners compress and position the breast helped improve efficiency while also helping patients feel more comfort

able during the process.

“I think some of the work we’ve done has provided our customers with con fidence that, regardless of personnel, they’ll be able to provide that efficiency, or spend more time with patients as they come back in order to build their relationship,” Izawa said.

FUJIFILM is also working in part nership with its potential customers to develop community health events that can drive awareness of the impor tance of annual breast cancer screenings while emphasizing technological solutions that promote patient comfort and confidence during the

“There’s a lot of awareness of known technology that’s being used to provide personalized care for dense-breast patients, or higher-risk patients,” Izawa said. “There’s also a lot of newer tech nologies that are being introduced into the market. People are transitioning into how we use these technologies to drive more of a personalized care approach to screening.”

All these high-end technologies are leveraged in service of early cancer detection, but they can’t be put to use if patients aren’t able to access them. To that end, Izawa also spoke about the need for mammography vendors to sup port clinical outreach programs that help connect women who should be screened for breast cancer with the health systems that can facilitate those studies.

“We’re partnering with our potential customers and holding events to create more awareness of how important an nual screening is,” he said. “The most im portant thing is driving early detection.”

exams. DNA methylation-based liquid biopsy technology allows physicians to screen patients for cancer with a blood draw rather than a tissue sample, as in traditional biopsies. Technological ad vancements in digital breast tomosyn thesis provide dense-breasted patients with additional insight into their cancer risk. Genetic profiling can help women with a family history of breast cancer to identify their risk levels on an individ ual level. FUJIFILM is also exploring dual-energy, contrast-enhanced, digital subtraction mammography technology, which offer a greater degree of accura cy in breast imaging. Discovering which patient groups are the best fit for which specific technological solutions helps improve their outcomes as well.

As critical as public outreach is to bringing women in for breast imaging studies, Tricia Trammell, imaging opera tions manager at the UT Southwestern Medical Center of Dallas, Texas, believes that getting them to come back year after year means employing staff who can manage patient anxiety with sensi tivity to the emotional intensity of their experiences. This is particularly signifi cant given the lapse in studies conduct ed during the pandemic: patients either had to reckon with the fear of skipping a routine screening, and thus, potentially missing a chance for early detection of an abnormality, or else weighing the risk of contracting COVID-19 for a non-ur gent health visit.

“After the height of the pandemic was over, when imaging services really ramped up again, many patients had a perceived sense of, ‘I didn’t have any testing done for this year and a half, and everything was fine,’ ” Trammell said. “ ‘Nothing happened to me while I didn’t have imaging, so what’s going to happen now? Will they find something because I didn’t stick to my

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annual screening schedule?’ ”

“Conversely, patients wondered if they were risking getting COVID from coming to the hospital or outpatient centers and being around other people, or should they delay longer and not be on their annual schedule and see what happens,” she continued. “Either way, you’re playing with fire, so that adds to the whole emotional factor that’s already underlying when you’re caring for and com municating with patients who are getting a mammogram.”

Trammell believes that the physical discomfort that

morning, and two of my patients were crying and shaking with fear,” she said. “I held their hands and hugged them and had an opportunity to remember why I am in this field; why I am in this industry. It’s to care for people and to help them through very scary situations.”

an irregular mammogram, schedule a biopsy, hold their hand through that biopsy, call the patient with biopsy results and coordinate follow up care.

It’s a game-changer as it relates to time between screening and diagnostic mammography, time between diagnos tic and biopsy, and time between biopsy and surgical referral.”

Trammell points out that access to care has been a historic problem for some segments of the imag ing patient population, and likely will continue to be so. For those reasons, she values community outreach programs that help either bring patients to imaging centers, or take the modalities into the community. But many mobile mammogra phy programs were shut down or limited during the pandemic, which underscores the deficit that communities lacking access to imaging technologies continue to face.

patients experience during a mammogram is secondary to the psychological discomfort they may be more intensely feeling during the lead-up to the study and during the study. As important as the results of the test are, the heightened emotionality of the experience around the cancer screening process puts an even higher premium on patient interactions.

“Often when a patient states that she doesn’t want a mammogram because it hurts, or when she delays in scheduling the exam, what she’s really uncomfort able about it is the unknown,” Trammell said. “Until they receive a benign or no-findings result, they’re emotionally uncomfortable. The story hasn’t changed in the 22 years that I’ve been doing mammography: it’s about early detec tion, access to care, technology and great compassion for people.”

“I did breast ultrasound imaging this

In addition to her imaging leadership role, Trammell is a certified patient nav igator, a process that she believes plays a critical role in removing the barriers to care that keep patients from accessing the imaging technologies that can save their lives through cancer screening.

“If a patient doesn’t know or have access to that technology because nobody navigated them to that tech nology, the technology doesn’t mean anything,” Trammell said. “An imaging navigator is going to call when there’s

“Most programs are now fully back up and running, and going full speed, but there’s no way to recover that year and a half that was lost,” Trammell said. “There’s no way to get it back. Now the focus is getting people back on their annual schedules, and finding any interval cancers that may have developed throughout that pandemic.”

Dr. Linda White Nunes is the University of Pennsylvania vice chair for inclusion, diversity and equity in the department of radiology as well as the division chief of abdominal imaging, Pennsylvania Hospital. She de scribed the impact of “dual pandemics” — one that has chronically kept patients away from hospitals, and another that acutely limited the lines of service that hospitals were equipped to offer amid virus surges — on community health initiatives aimed at improving breast cancer screening for people who strug gle to access imaging services.

Siemens Healthineers North America employees attending the inaugural Penn Medicine/Siemens Healthineers mobile mammography screening outreach event, held Oct. 18-29, 2021, in North Philadelphia, include Abigail Weldon, Senior Director of Women’s Health; Lara Barghout, Senior Vice President of Advanced Therapies; Nina Marino, Project Support Analyst; and Francis “Franny” Gentile, Project Assistant.
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“Sometimes it’s hard for us to sepa rate the effects of the two pandemics,” Nunes said. “There’s a well-described delay in care associated with COVID. Even after that acute six to 12 months, people were fearful of coming back for things that weren’t urgent for fear of contracting COVID. We feel that we are just now making up for that time, and catching cancers that may have devel oped during that period.”

Nunes cited CDC reports of approx imately 41 percent of American adults avoiding medical care, and 32 percent avoiding routing care during the pan demic; an in-house survey of patients presenting to a University of Pennsylva nia breast imaging center found that 26 percent reported delaying care during the pandemic. Those affected were younger people who often had house hold responsibilities, or had contract ed COVID themselves, she noted. In addition to the impact of the pandemic, Nunes also described the weight of the social unrest following the murder of George Floyd in police custody, which led to broader, louder discussions about health disparities and social determi nants of health.

“People were not presenting at hospitals to get the screenings they should,” she said. “We chose to try to combine a community partner, a corpo rate partner, and ourselves, to see if we could get beyond the social determi nants of health.”

Those partnerships proved fruitful. Siemens Healthineers North America provided the mobile imaging suite, delivered on a semi-trailer affection ately nicknamed “Mammo Mandy.” The Murrell Dobbins Career & Technical Education High School in the West Lehigh neighborhood of Philadelphia hosted one event, and the Community of Compassion CDC, a 5,000-member congregation in West Philadelphia, hosted another.

The first event was dedicated spe cifically to breast imaging, while the second provided breast, colon, and prostate cancer screenings, followed

by another two weeks of onsite breast cancer screenings with the mobile unit. At Community of Compassion, the larger health fair also included opportu nities for residents to undergo lung can cer risk assessments, familial or genetic risk assessments, and education about clinical trials and research.

“We wanted to both educate and screen on that day,” Nunes said. “Their leadership is really in touch and in tune with their community, and their commu nity really trusts them.”

The events were both successful not only for their locations, which were well-known within the community, but also because of the connections their community partners had built within the neighborhoods. Nunes described the reach that the Community of Com passion has within the community as extensive and meaningful. In addition to the guests in the sanctuary, the church also livestreams its services to congre gants, which brought in women from throughout the city.

“One of the people at the mammog raphy van that day said she was home watching the livestream of the service,” Nunes said. “Between the pastor and the physicians saying how important it was, she said, ‘I’ve got to get out of this house, and get down there and get screened.’ Other people said a friend said the same thing to them.

“Having friends, community leaders and people you trust telling you, ‘You’ve got to do this and I’ll walk down there with you,’ that’s important,” she said.

Abigail Weldon, senior director of women’s health at Siemens Healthineers North America, said the partnerships proved fruitful for everyone involved.

“Penn Medicine is one of our most valued partners, especially in the Philadel phia area,” Weldon said. “We located the space, and provided the equip ment and the project

management – and 241 women got their mammograms in a two-week span with very little marketing.”

“That solidified for both Penn Med and Siemens that there is a need that I don’t think we’ve even quantified yet for us to be in inner cities,” she said. “Mobile mammography is not just for rural areas that don’t have access.”

When it comes time to measure the success of community initiatives like these, there are quantitative and qualitative takeaways, Nunes said. She pointed to the higher-than-expected number of cancers among patients post-pandemic as evidence that the programs are reaching people who do not ordinarily come in for routine screenings. Penn Medicine is working to create a program using a smaller mobile unit – one capable of rotating through the city on a regular schedule – to ex pand upon their successes.

“There are health centers that are not doing breast imaging, and you could roll up to their parking lot,” she said. “So we definitely see a lot of potential, and hopefully we’ll be able to give that type of program a try soon.”

Weldon also believes that any efforts that can be made to address health care disparities in general aree significant, and specifically those that have been exacerbated by the pandemic.

“We won’t know the true effect of the pandemic for years to come,” she said. “We are seeing health care providers also pivot to make up for the lost screening. I think that’s where we can have a sense of hope. There’s a lot of movement around getting these screening services to the non-tradi tional space.

“We were on a good path when it came to screening, and seeing less deadly effects of breast cancer,” Wel don said. “We need to be in more spaces when it comes to screening.”

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• COVER STORY

FROM HEALTHCARE ADMINISTRATOR TO IMAGING PATIENT A Journey Through Perspective

For more than 22 years, I’ve worked in the medical imaging field. I chose medical imaging because it encompassed a wide array of procedures and technologies – all of which interested me. As someone who appreciates multi-tasking, I quickly was immersed in the diversity, challenges and opportunities this field provided. I also understood that a journey in this field could – and ultimately would – lead to leadership roles.

My learning journey began working alongside radiolo gists, waiting on them patiently to finish up a dicta tion to rush them to perform the following procedure. After witnessing countless interruptions, I realized I would become an advocate for educating team mem bers on the importance of the radiologists’ role and how to be respectful of their time.

I began to advance into leadership roles, first serv

ing as a site manager and then moving into my current role as the operations director for Banner Imaging. I’ve worked on building teams, focusing on collaboration and instituting cross-training objectives. It’s all about perspective – giving team members the opportunities to understand and be immersed in the diversity, challeng es and opportunities connected to each role within the business. Not only does this bring awareness, but it also brings about heightened respect for one another.

We focus on patient care through perspective, and the phrase, “Every time, every patient, every moment,” has become our mantra. This mantra is at our core because it upholds our commitment to providing excellent care.

Throughout my professional journey, I’ve personally learned perspective.

Having worked alongside radiologists and technol ogists, I’ve always respected their roles. Many patients need scans and are awaiting results that can potentially change their lives. As radiologists and technologists, your focus must always be steadfast and accurate. You’re the person who determines the good or bad news – and

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I’ve been a part of it. I’ve often stood there as patients hear the words, “You have cancer.”

One day in early 2022, I was diagnosed with breast cancer. Suddenly, after 22 years in the medical imaging field, I was the patient. I was now being treated and cared for by the very team I worked with. I knew what went on behind the scenes as the diagnosis came, but I’d never experienced it as the patient. I was scared and overwhelmed – a million thoughts and questions swirling in my head – as my new reality hit me. But the compassion, genuine concern and support the team showed in delivering the news gave me hope and comfort.

By the grace of God, prayer and excellent doctors and tech nologists, I got through my di

agnosis and came out the other side with strengthened faith and heightened respect for what we do every day in the medical imaging field. The radiologists, imaging assistants, referral coordinators, technologists, site managers and all others in this field work hard, doing important work that impacts countless people daily.

As November approaches, I encourage those who work with, know of, or have family members or friends who work in this field to celebrate National Radiologic Technology Week. Happening from November 6-12, this year’s theme is “Aiming to Heal.”

Our radiology team mem bers aim to heal, and we should celebrate their commitment to our care with every time, every patient and every moment. •

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FIRST IMPRESSION CAN CREATE LASTING IMAGE

often a successful screening mammography program is the beacon of light for an imaging practice. For many patients it is the first encounter with imaging. It is our opportunity to make an outstanding first impression. These patients are judging our centers on cleanliness, friendliness and quality. It has been shown that women are likely to make the health care decisions for the entire family. A wellrun mammography program can lead patients through all the rest of our modalities as well as into our acute care facilities for their care.

Banner Imaging currently has seven Breast Im aging Centers of Excellence as well as several other sites offering mammography. Women’s imaging is complicated for many reasons. We have looked for ways to make our process quality driven and efficient, as well as compas sionate and empathetic. Even women com ing for their annual mammogram have that moment of dread when the voice in their head says, “What if they find something?” Not that this is any different than all our other patients having any exam for any reason. It is that this is a screening exam that you have every year, not ever expecting anything to be wrong.

To create a more comprehensive program, Banner Imaging now offers genetic testing through Ambry Genetics, a company that per forms genetic testing for hereditary cancer. Through a health history form, patients are

screened to determine who may benefit from the testing. Patients that qualify submit a saliva sample and receive results through the Ambry portal. Results are also sent to their re ferring physician. We have partnered with the genetics program with Banner MD Anderson for continuum of care. Ambry Genetics also has a team of genetic counselors that can assist patients with understanding the results so they can make informed decisions.

Regardless of the technology within any successful mammography program, it is the people employed in the program that will make or break it.

Every area of imaging is short staffed right now. In order to cultivate the next genera tion of successful mammo techs, we have partnered with a local community college to create a mammography education program. Amy Peronace, director of women’s imaging at Banner Imaging, has accepted a position as an adjunct professor at Gateway Community College in Phoenix. This program is brand new. She has worked to develop the curricu lum with national mammography education leaders to ensure the program will produce skilled, well-trained technologists. Many techs find their passion in mammography because of a personal experience. This education will give them the tools they need to put their mark on women’s imaging.

This program will not only help Banner Imaging fill the gap in staffing mammogra phy, but it will also help others in our com munity that provide this service. It may also allow technologists that have not had

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the opportunity to move into a cross-training position be proactive and ready to achieve a career goal.

There are also non-technologists on our women’s imaging team that make a difference. We have interventional breast schedulers, medical imaging assistants, patient access representatives and oth er support staff that serve in our breast imaging centers. Our entire team has an impact on the patient experience. Those that need to return for additional views, an MRI or biopsy are even more anxious when they return. It is at this time that we can really go the extra mile, whether it is by the technologist or any other team member. Those soft skills are what make the difference.

I often see comments on our Medallia survey from patients that come back to our centers year after year to see the same technologist. Our patient trusts them and, in some cases, even look forward to seeing them, de spite the fact that a mammogram is the reason to do so. It is a culture of caring that I see described in those comments. “We’ve got you; we are on

your team,” is the message we are trying to convey.

Just a quick note on another topic. Whether it is MRI, CT, PET/CT, diagnostic radiography, fluo roscopy, DXA, ultrasound or mammog raphy, we are dedicated professionals that have worked very hard to hone our skills. Imaging requires technical ability, advanced education, emotional intelligence and compassion. With Rad Tech Week coming up, it is a good time to address something that I first heard about in the first week of radiology training. We are technologists, not tech nicians. We don’t fix our equipment, not that we haven’t all figured out a work around to keep a unit going.

I would like to propose that we work together to educate on this subject. I understand how the average person may not realize the difference and I am OK with that. Other health care professionals, as well as corporate partners that are working to convince imaging leaders to purchase their products, should know the difference. Thanks for all you do! •

Beth Allen, RT(R)(CT), CRA, is the director, clinical operations at Banner Imaging.

Regardless of the technology within any successful mammography program, it is the people employed in the program that will make or break it.
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A CODE OF ETHICS FOR ARTIFICIAL INTELLIGENCE AND IMAGING

iwas reviewing a portable X-ray contract last week when the salesperson sent an addendum that listed an add-on for $14,870. I picked up the phone and called the salesperson.

I asked, “What does this add-on do?” The reply was, “It diagnoses a pneumothorax.”

I did not order the add-on.

If there is a positive finding, 1 in 1000 chance, who and how will a notification be sent out to act?

Is it ethical to sell a product like this knowing that medi cal decisions can be made from this unreviewed “diagnosis.”

Of all the industries romanticizing artificial intelligence (AI), health care organizations may be the most smitten. Hospital executives hope AI will one day perform health care administrative tasks such as scheduling appointments, entering disease severity codes, managing patient lab tests, managing referrals, and remotely monitoring and respond ing to the needs of an entire cohort of patients as they go through their daily lives.

By improving efficiency, safety and access, AI might be an enormous benefit to the health care industry.

But caveat emptor, buyers of health care AI need to consider not only whether an AI model will reliably provide the correct output – which has been the primary focus of AI researchers – but also whether it is the right model for the task at hand. I believe we need to think beyond the model.

This means executives should consider the complex in terplay between an AI system, the actions that it will guide and the net benefits of using AI compared with not using it. This should be done before executives bring any AI system on board. They should have a clear data strategy, a means of testing the AI system before buying it and a clear set of metrics for evaluating whether the AI system will achieve the goals the organization has set for it.

Here is the simple rule of thumb, “In deployment, AI ought to be better, faster, safer and cheaper. Otherwise, it is useless!”

I have been involved with some AI vendors. I was pleas antly surprised to find how efficient their models could be trained. I was reviewing the results with a data scientist. As we discussed a CT AI algorithm, I asked the scientist, “How long have you tested this product?” The reply was 18 months. I next asked, “What were the protocols utilized to generate the data that was consumed by the algorithm?”

The engineer stated, “One-millimeter slices overlapping at 0.75 millimeters provided the outcomes.” This is a key point – an AI engineer does not understand ALARA.

Each CT chest, abdomen and pelvis exam would be 10,000 slices. This is not how the health care world works. The software engineer said he is not responsible for the performance of the algorithm if I did not give it the right datasets.

This reminded me of a professor at the University of Tex as that I met at a Society for Imaging Informatics in Medicine (SIIM) conference about 15 years ago. He said, “I can train a robot to mow the lawn. I can also train a robot to change a baby’s diaper. What my robot will never be able to do is care if it is changing the lawn or mowing the baby.”

To them, it is a mathematical exercise to produce the most favorable output. It is up to us – as the consumers of artificial intelligence in imaging – to ask the right questions.

A salesperson will tell you about the wonderful things AI can do if you use it the way it was designed by the engi neers of the world. A salesperson wants to make a sale. It is up to the leadership in imaging to safely deploy well understood and real-world tested AI in imaging. •

Mark Watts is an experienced imaging professional who found ed an AI company called Zenlike.ai.

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MANAGING MEDICAL ERRORS WITH AI AND INDUSTRY LEARNINGS

The health care industry has many safeguards to ensure high-quality care is provided throughout our nation’s hospitals. Yet, medical errors continue to harm an estimated 1.2 million individuals each year. Throughout the managing medical errors series, we’ve explored how other industries use AI to mitigate human error. A quick recap includes:

• Credit card companies find and man age fraud using AI to detect abnormal behaviors

• The airline industry’s dual approach to errors uses a systematic checklist to limit avoidable mistakes and a confi dential error reporting system to ensure problem-solving

• In the energy industry, multiple, re dundant safeguards limit and prevent accidents and errors

The strategies implemented across different industries prove that technologies such as AI can help practitioners provide health care more effectively and prevent medical errors. We wrap up this final article in the series by examining ways AI can drive patient safety, improve outcomes and mitigate medical error.

AI PEER REVIEW IN THE QUALITY WORKFLOW

Standard throughout the health care indus try, peer review is a method to double-check results and accuracy of image interpretation and, ultimately, clinical diagnosis. Working within this framework, only 3-5% of all diag nostic images receive a second review. This

represents a very small slice in relation to the total volume of diagnostic imaging studies conducted each year. The standard peer re view process can be enhanced by utilizing AI, enabling a second review on a much larger number of diagnostic images. Adopting AI as a second read across all imaging scans is critical in positively mitigating medical errors.

The quality workflow leverages computer vision and natural language processing to monitor for missed findings on diagnostic images. The quality workflow uses AI to high light results of interest, identify discrepancies between imaging and documentation and positively impact the incident of errors of omission. The quality workflow is a back ground process, providing a review of image and documentation for possible discrepan cies while not interfering with the radiolo gist’s workflow. Implementing the quality workflow ensures medical team members are empowered with the appropriate insights to act upon while providing timely medical care.

Rectifying medical errors goes beyond identifying a concern, follow-up communi cation and coordination are critical steps to ensure appropriate patient care. Using diag nostic and administrative algorithms, health care systems can manage follow-up care and specialty consultations in a robust, automat ed approach. For example, AI can trigger automated scheduling of follow-up visits, specialty consults, patient reminders, and preventative screening, ensuring all patients receive the same level of care based upon their medical needs.

ELIMINATING BIAS AND ADDRESSING HEALTH DISPARITIES

Bias within the health care industry is well

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documented and guidance has been provided to ad dress these biases in developing AI algorithms. Utilizing de-identified data from a diverse population of patients can relieve unconscious bias and improve health out comes for all patients.

AI enables improved access to high-quality care for underserved patient populations. Delivering essential health services to less developed countries is possible through Autonomous Mobile Clinics (AMC) and AI “doctors.” The deployment of AMCs can provide high-quality, low-cost medical care to underserved communities. By improving access to care, AI can bridge the health disparities gap.

AI used in proactive health maintenance endeavors to keep people healthy, assesses risk and informs patients of the care they need before a health problem arises. This is AI functioning on a population health level, driv ing health equity.

NEXT STEPS IN AI IMPLEMENTATION

With more than 1,500 health care AI solutions available in the market today, health care systems are navigating a daunting path to systemwide AI deployment. Health systems ask, how do we give our clinicians and patients in different regions and facilities the clinical AI tools they need in a reasonable time frame without losing control of IT, security and costs?

Aligning with an Enterprise AI platform partner can address these questions and manage additional common barriers to AI implementation. A robust AI platform provides seamless implementation of a hospital’s initial AI strategy while planning for future growth. •

Revisit the series online at theicecommunity.com/category/magazine/insights/chew-on-this.

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EMOTIONAL INTELLIGENCE

NOW IS NOT THE TIME TO CUT TRAINING

It happens every time our country has a downturn in the economy. Training budgets get slashed. After more than three decades, I’ve seen it happen every time. The problem is that organizations inflict unseen damage on themselves by making the mistake of slashing training budgets.

Over the past few years, America has seen hiring signs just about everywhere. Businesses of all types are beg ging for people to come work for them. In my state, nurs es are in such short supply that hospital systems are of fering starting salaries of more than $100,000. This means that many existing employees are already stretched and strained, and mistakes are being made.

I know this because nurses are telling me this is the case.

Sadly, the trend of training budgets being cut is re-emerging with the latest recession. As just one exam ple, an acquaintance who has been a corporate trainer for decades (let’s call him Thomas) recently called to tell me his Fortune 500 company was making the budget-slash ing mistake. His own job is not in danger, but as a trainer, he’s already seeing the negative ripple effects of training cutbacks.

“We developed an excellent onboarding system,” Thomas told me. “When someone got hired, there was a system in place to ramp them up so they could be in the field in less than four weeks. That means they were profit able to the company in relatively short order.”

But with a huge cut in the company’s training budget, dozens of trainers were let go, and the onboarding system was redesigned. “We went from 12 new-hire trainers down to six,” Thomas said, “and new-hire training went from four weeks down to two – with one of those weeks being

nothing but job shadowing.”

The result? New hires are being placed in field posi tions without the knowledge to be effective, and they’re making a lot of mistakes. Thomas also says the budget cut has affected turnover. “People who would normally stay and be productive for us are quitting after just a few weeks because they feel inadequately trained for the job,” he said.

Job shadowing has its place, but many people – even professionals in their field – do not understand the me chanics of transferring knowledge and skills to someone else. Watching someone do something is very different from being able to adequately perform the same skill.

CURRENT EMPLOYEES ARE ALSO IMPACTED

Cutting a training budget also affects current employees. Training brings confidence to employees who receive it because they know their company is investing in them. In our current economy, that goes a long way.

On the negative side, if employees are being asked to produce high-quality results and do more with less, but are not being trained to do it, they easily feel over whelmed and even used. This leads to people looking for work elsewhere. As already mentioned, “Now Hiring” signs are fairly ubiquitous these days, so it doesn’t take much for overwhelmed and expensive-to-replace employees to look for work elsewhere. This is what I mean when I say that most companies can double their training budget and actually save money.

HOW TO ENSURE TRAINING IS PROFITABLE

Measuring return on investment in training is a comprehensive, systematic process that most companies won’t bother to do. However, I can report that from my

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experience as well as from the data I’ve read on this subject, the overwhelming percentage of training does provide a financial return. In fact, it is not uncommon for some training programs to provide an ROI of more than 900%. The problem is that we never see “Training ROI” as a line item in a budget. Executives rarely see that many training programs are actually quite profitable.

What follows are some tips for helping to ensure your organization’s training programs will provide an ROI.

1. Make sure your training addresses an issue that training can solve. Too many times a company will expe rience something negative and decide to throw training at the problem, without identifying the real problem. Example: A survey showed that a company’s customer service department was getting bad marks, so they decid ed the solution should be new customer service training for everyone. Except that the real problem wasn’t poorly trained employees, but rather a rude and stingy manager who believed the customer was always wrong. No amount of customer service training for frontline employees was going to help so long as the rude and belligerent manager stayed in his position.

2. Ensure all training is tied to the company vision and mission. If a company seeks to be the best repair compa ny for widgets, training should focus on helping people repair widgets better. When budgets are tight, training that doesn’t help the organization work together to repair widgets should be set aside.

3. Ensure all training is tied to specific results desired by the company. The three questions that follow will help ensure training focuses on desired results.

a) What results are expected from the training? Do you want repairs to be completed within a certain time frame? Do you want all repair techs able to repair a new prod uct line? Make sure your answer to this question about expected results is specific, and that it aligns with item #2, above. Most importantly, do not answer the next question until this first question is answered.

b) What behaviors will get those results? Your answer to this question clarifies what employees must do so the above expected results can be achieved. Be specific. What must employees do? Again, don’t move forward until this question is answered.

c) What knowledge, skills and attitudes (safety and quality concerns) must employees have to perform the needed behaviors? Your answers to this third question will set the framework for your training, and it’s here where having a training professional is most beneficial.

Slashing the training budget limits a company’s ability to provide focused and purposeful training, and when that happens, unseen damages occur. The problem, as stat ed, is that these damages do not appear as obvious line items in a budget, so they are not realized until after the damage is done.

Daniel Bobinski, who has a doctorate in theology, 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 by email at DanielBobinski@ protonmail.com or 208-375-7606.

ICEMAGAZINE 49WWW.THEICECOMMUNITY.COM
[ QUOTE OF THE MONTH ] “Leadership is the capacity to translate vision into reality.” – Warren Bennis ICE Break 9 6 5 4 8 6 1 2 5 1 6 9 7 8 6 2 5 4 7 4 3 6 5 1 9 7 Puzzle by websudoku.com YOU COULD WIN! Take our short ICE magazine readership survey. The first 100 respondents will receive a $5 Amazon Gift Card! theicecommunity.com/readers/ TAKE THE SURVEY EARLY TO CLAIM A GIFT CARD! SCAN FOR SURVEY ADVANCING THE IMAGING PROFESSIONAL50 ICEMAGAZINE | OCTOBER 2022

THE ROMAN REVIEW

TASKING: MULTI AND SWITCH

Iwoke up this morning with much anxiety. My mind was reeling from all the things that I absolutely had to do today. I attempted to conduct my normal morning routine anyway. I retrieved my morning coffee and sat for my morning aggravation of “news” coverage. However, my mind would not cease the continuous movie reel of all the items on today’s agenda:

• Clean up after last night’s Vegas Monsoon – 2 hours

• Troubleshoot the pool pump failure – 2 hours

• Update AMSP.net with the annual winter meeting infor mation – 1 hour

• Set up the online voting for new AMSP Board officers - 1 hour

• Decide and research what to write about for this column – 3 hours

• Write and revise this column – 1 hour.

TOTAL – TEN HOURS!

Seriously, these are the actual times that my mind antici pated for each project. I don’t think these times are based on previous experience. They can’t be correct since actual pre vious times are wildly different. The stress of the many items probably expands the perceived time frames.

So, I did as everyone else does. I prioritized and assigned urgency and importance to each task. This proved very difficult because they all seemed to have the same levels of urgency and importance. I realized that this analysis should have been performed yesterday at day’s end. This is what you and all good time managers do. However, my day is not often so full. I then came to the conclusion that the two of you who anxiously await this column every month would be the first priority.

I thought that maybe I could do a little multitasking or switch tasking which caused me to actually research the differ ences. Maybe this is why my brain assigned such a large block of time to research. Once I get on the Internet, I am sidetracked by all those opportunities to see and learn new stuff. I immedi ately wind up in switch tasking mode. But, I digress.

Multitasking is when we perform related tasks which are automatic or can be performed unconsciously. Walking and chewing gum or driving while also looking in the mirrors for

safety, come to mind. When we add texting to these, we are now applying a task that intrudes into the automatic and unconscious tasks. This invasion requires attention that can be very dangerous in the examples and, in safer instances, reduce focus, productivity and expand required completion time. This is switch tasking.

Switch tasking forces the brain to switch focus, in itself a time-consuming process. The time required for the new infor mation to be processed by the short-term working memory –reorientation time. When new stuff comes in, some of the stuff already in there has to be moved out. As we move from one task to another, focus time is lost as well as focus itself. Accord ing to research, switch tasking reduces productivity, increases errors and increases the time needed to complete the tasks. Of course, it also increases stress, discomfort and impatience.

There are people who enjoy switch tasking although they call it multitasking. Some may feel more productive, and even enjoy the stress. It provides bragging rights to be able to switch tasks. Some switch tasking is less harmful. Watching TV, texting and eating chips may not be as harmful as texting or emailing during an important business meeting.

It is a common misconception that the young are better at switch tasking than we old people are. Actually, they are just more practiced at it. They may be subjected to many more distractions and interruptions that redirect their attention. They may also be more prone to the errors and other harmful byproducts of multitasking.

It is interesting that many job descriptions, as well as resumes, highlight the ability to multitask (switch task) as an asset or requirement. In this case, I believe what is intended or should be intended, is the ability to move to and focus on a higher priority task quickly and efficiently without freaking out.

I am almost done with this task. I was able to provide good focus to it. The only interruption has been the hummingbird that appears at the window beside me to say good morning. As I complete this task, the other tasks are starting to encroach on my thoughts. Oh hey, there’s the hummingbird again. •

MANNY ROMAN
INSIGHTS ICEMAGAZINE 51WWW.THEICECOMMUNITY.COM

SHORT

of Medical

AMSP ADVANCING THE IMAGING PROFESSIONAL52 ICEMAGAZINE | OCTOBER 2022 IMAGING 1-800-421-2402 sales@interstateimaging.com Expert Engineers. Complete Support. Exceptional Quality. Complete Customization. One Point of Contact. Offering the best reliability and support in the medical industry, just for you. 800-541-0632 brandywineimaging@comcast.net READY TO HELP YOU IDENTIFY YOUR IMAGING NEEDS WE FOCUS ON PEOPLE, INNOVATIVE PRODUCTS, AND SERVICE EXCELLENCE 800-722-1991 radonmedicalimaging.com 440-724-7511 STEVE@MAULLBIOMEDICAL.COM MAULLBIOMEDICAL.COM CONTRAST INJECTOR TRAINING OPERATION, SERVICE, AND TROUBLE SHOOTING King’s Medical Group 800-854-9061 contact@kingsmedical.com LONG TERM RESULTS
TEAM SOULTIONS FOR AMSP MEMBERS The Association
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.

MEMBER PROFILE RADON MEDICAL IMAGING

Radon Medical Imaging is a unique provider for imaging sales and service in the U.S. With sales and service in an ever-expanding product portfolio, Radon is well positioned to grow and expand in the coming years. R adon currently serves WV, VA, OH, KY, TN, NC, SC, DE, MD, PA, GA and D.C

ICE recently found out more about the company via a ques tion-and-answer session with Radon Medical Imaging CEO Andy Border.

Q: WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER?

A: Radon not only services what we sell, but also offers a wide range of service and contract options for multi-vendor/multi-mo dality imaging equipment. From the product standpoint, Radon’s exclusive territorial dealership for

United Imaging products is most exciting for us and our customers.

Radon, in the past year, has expand ed our install base with multiple Unit ed Imaging MRI, CT and PET-CT instal lations throughout our coverage area.

Q: WHAT HAS BEEN YOUR COMPANY’S BIGGEST ACHIEVEMENT?

A: Maintaining very high customer satisfaction as we have expanded both our geographical territory and product lines.

Q: DO YOU HAVE ANY GOALS YOU WOULD LIKE TO ACHIEVE IN THE NEAR FUTURE?

A: Continue to expand our customer base within our sales/service terri tory and look for strategic alliances with other imaging sales/service companies to expand our territory.

Q: IS THERE ANYTHING ELSE YOU WOULD LIKE OUR READERS TO KNOW?

A: Radon is ever-expanding. We welcome opportunities to increase our customer base and continue to seek out the very best talented individuals to join the Radon team!

For more information, visit radonmedicalimaging.com.

AMSP ICEMAGAZINE 53WWW.THEICECOMMUNITY.COM

ADVERTISER INDEX

Advanced Health Education Center p. 23

Association of Medical Service Providers (AMSP) p. 52

CM Parts Plus p. 47

Diagnostic Solutions p. 41 HTMJobs.com p. 34 ICE Webinars p. 18

Injector Support and Service p. 19 Innovatus Imaging p. 3

KEI Medical Imaging p. 47 KMG p. 26 Mammo.com p. 2 Maull Biomedical p.45

PM Imaging Management p. 45

Rad Rays LLC p. 55

Ray-Pac®

Medical Imaging Solutions p. 9 MedWrench p.28

Ray-Pac p. BC Summit Imaging, Inc. p. 13 Technical Prospects p. 4

Three Palm Software p. 25

Metropolis International p. 29

MW Imaging Corp. p. 5

SOLUTIONS

TriImaging Solutions p. 30 W7 Global, LLC. p. 29

INDEX ADVANCING THE IMAGING PROFESSIONAL54 ICEMAGAZINE | OCTOBER 2022
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