Back on Track: Radiology Moves Forward with a Sharpened Focus on Priorities

With increasing COVID-19 vaccinations worldwide, healthcare providers are moving forward and getting back to routine patient care in a “new normal” healthcare environment that includes increased cleaning and safety protocols, new scheduling and waiting room procedures and new methods of patient communications.

As a critical entry point in the diagnostic process for COVID-19 patients as well as in many other health conditions, radiologists are tackling the backlog of imaging procedures that had been postponed during the height of the pandemic. In addition, they are managing the ever-increasing volumes of new requests for imaging exams, as most facilities are now operating at or near 100 percent. But one thing is certain, despite the need to focus on COVID during the height of the pandemic, the priorities that were identified in the pre-pandemic world haven’t changed and radiologists are refocusing their attention on these priorities.

Managing increasing system complexity, strained budgets and staff shortages, today’s radiology departments are feeling a tremendous need to improve efficiencies, while keeping costs low. In an IMV report on Global Imaging Department Priorities and Outlook, radiologists who responded reported their top departmental priorities as:

• improving department workflow efficiency and productivity,
• improving patient satisfaction,
• and keeping their department up to date with state-of-the-art technology^[1].

Health systems and industry partners alike are continually working on solutions to improve efficiencies in the radiology workflow and finding solutions that might alleviate radiology burnout to improve radiologists’ day-to-day work environment.  

Improving Radiology Department Workflow Efficiency and Productivity

In addition to the stress on the healthcare system caused by the pandemic, the shortage of specialty physicians such as radiologists is causing additional strain on productivity and bottlenecking workflow. According to the Association of American Medical Colleges, the United States could have a physician shortfall in 2033 close to 139,000 including nearly 42,000 radiologists and other clinical specialists. This is significantly higher than the previous shortfall projection of 91,500 physicians for the US by 2020.

Other countries are showing similar trends. In the UK, the Royal College of Radiologists found the existing radiologist shortage is 1,104 with the possibility of increasing to 1,867 by 2023, which is concerning when compared with the ten percent year-over-year increase in demand for CT and MRI scans reported since 2013^[2]. According to the IMV report, only 26 percent of respondents felt their current operational capacity was sufficient to meet their anticipated growth in procedure volumes over the next two to three years.

The physician shortages are putting pressure on systems already constrained by limited resources, aging populations, and complex funding challenges. One of the glaring results is physician burnout. In another recent survey, forty-five percent of radiologists reported symptoms of burnout^[3].

Given that radiologists’ workload will likely only increase during the pandemic recovery period, there is a major industry focus on process improvement efforts that can make workflows more efficient and improve productivity. In addition to the artificial intelligence (AI) applications the healthcare industry is already using to automate many tasks, such as simplifying procedures and cutting down on administrative errors, many new AI technologies are focused on clinical applications and the IMV report indicates that many radiologists, especially those in larger healthcare facilities are ready to adopt them. Radiologists can find some of the most current AI initiatives in areas such as triage, diagnostics, and patient management.

While AI-based innovations have the potential to support significant improvements in workflow and clinical decision support, radiologists remain cautiously optimistic with concerns that AI innovations will be adopted piecemeal, vary across imaging devices, further increase workflow inefficiencies, or contribute to a growing training burden.  

GE Healthcare, as well as other industry leaders, is focused on addressing these concerns and facilitating the adoption of AI-based and other digital solutions that can increase efficiencies across the entire radiology workflow without increasing the administrative and training burden on radiologists and technologists. To date, GE Healthcare has released tools such as AI-embedded algorithms to automate lesion measurements on image reconstructions, perform case prioritization and execute quality control features. On X-Ray systems, for example, GE Healthcare has developed automated tools intended to assist technologists with correct anatomical positioning and confirm protocol selections at the time of the scan, and auto rotate images to save time for reading radiologists. To improve triage of urgent cases, the on-device AI algorithm also automatically analyzes images, upon acquisition, for critical findings such as pneumothorax. Triage notifications are sent directly to PACS and flagged for prioritized radiologist review.

”Our goal is to help radiology achieve intelligent efficiencies so that they can work smarter instead of harder. In addition to the innovations we are developing internally, we have created a secure intelligence platform, Edison™, to support and disseminate the innovations of independent developers, whose applications can benefit the radiology space,” says Roshni Bhagalia, PhD, Vice President, Product Management, Edison Health Services

GE Healthcare is supporting the efforts of third-party developers’ radiology solutions through the Edison™ Developer Program. The program was created to facilitate the development, adoption and impact of new AI tools and developer services across health systems. The program is based on Edison, GE Healthcare’s secure intelligence platform, and helps healthcare providers gain easier access to market-ready algorithms and applications by directly integrating these technologies into existing workflows.

Improving Patient Satisfaction with Innovative Collaboration Tools and Data Analytics

Creating a positive patient experience and improving patient satisfaction is also a top priority for radiology. The adoption of digital tools to facilitate collaboration between radiologists and other members of a patient’s care team may positively affect patient satisfaction^[4]. While healthcare providers strive to adhere to care-delivery models that consistently improve patient outcomes and experience and lower healthcare costs, achieving these goals simultaneously can be challenging.

Due to the growing complexity of healthcare systems and the recognition that no individual healthcare provider can deliver comprehensive patient care independent of the patient’s other care providers^[5], new tools that allow physicians to virtually collaborate about their patient’s care by sharing imaging data and other clinical information have become widely adopted. These tools have the potential to increase radiologists’ involvement in multidisciplinary teams and clinical decision making, as well as reducing the number of rescans or unnecessary investigations, and getting patients on their treatment paths quickly.

Another path to improved patient satisfaction includes creating a patient-centric experience with less time spent in waiting rooms, faster exam times, and reduced time to diagnosis. Optimizing the radiology workflow can better manage the expected growth in volume of requests for imaging procedures and organize scheduling to reduce the amount of patients’ wait time. AI tools to help radiologists triage urgent cases are enabling the most critical patient images to be read quickly that may result in improved time to diagnosis and to potentially improve patient outcomes.

New AI tools can also help visualize and facilitate departmental operations as well, using predictive staff scheduling based on utilization analysis. Understanding department equipment utilization through better data visibility, integration, and analysis help radiology teams optimize workflow, increase staff performance, and make more informed decisions. State-of-the-art imaging technology that delivers high-resolution clinical images and allows faster exam times also supports improving patient satisfaction. Advances in Computed Tomography (CT) imaging technology for cardiac imaging for example, enable the completion of scans less time using less dose and without reducingimage quality, which can allow  for a quicker and potentially more comfortable experience for the patient^[6]. Newly designed user-interfaces on some imaging technologies can now automate some of the technologist’s tasks, such as patient positioning, so the technologist can spend more time with the patient explaining the procedure and answering any questions the patient may have.

Keeping Radiology Up to Date with State-of-the-Art Technology

Providing patients with the right diagnostic imaging exam at the right time to maximize their health outcomes is a key underlying perspective supporting radiologists’ priority to maintain state-of-the art technology in their departments. But with the cost of healthcare continually on the rise, reimbursement continually on the decline, and budgets being squeezed, capital expenditures for new equipment purchases are not easily obtained. Understanding the clinical value and potential return on investment from these technologies, radiology department leaders continue to prioritize acquiring state-of-the art imaging technology not only to offer their patients the latest in imaging solutions to support better diagnostic outcomes, but also to support the hospital’s market position and long-term revenue goals.

Meeting the needs of the referring physician community or a specific patient community with the imaging technology necessary to provide care for them is also a priority. Some hospitals and radiology departments have purchased new equipment or are considering a purchase in order to expand a clinical service area such as cardiology, for example, and perhaps to better serve a specific patient community that reports higher levels of heart disease. The potential to improve clinical diagnostics and outcomes with advanced technology is an obvious result, but the hospital or radiology group can also benefit from more consistent imaging with advanced protocols and staff training, as well as higher reimbursements from more complex imaging procedures. Understanding the current and expected future reimbursement scenarios from a new technology acquisition as well as projecting its return on investment and impacts on staffing and training are essential.

An equally important priority for radiology departments and hospitals is to optimize the operation and continued maintenance of their current fleet of imaging equipment by conducting routine maintenance and providing staff with on-going equipment training. For those hospitals or radiology departments that continue to operate existing equipment, pursuing software and operating system updates that can optimize efficiency and workflow is key, enabling the ability to manage increasing patient volumes.

With increasing adoption during the pandemic, industry leaders are offering customers the ability to remotely monitor imaging systems and conduct routine maintenance remotely. Staff training and continuing education can also be completed virtually, so staff can keep abreast of the latest imaging techniques and protocols that can help inform their patients’ diagnoses.

Radiology’s contribution and dedication to patient diagnostics is considerably important, as is the radiologist’s ongoing collaboration with the patient’s care team. For hospitals and health systems to have a better understanding of radiology’s role in patient care and patient satisfaction, it’s important that radiology remain focused and achieve greater workflow efficiency, improved patient satisfaction and use the latest in imaging technology that is accessible to them. Partnering with clinicians and industry leaders to solve the challenges faced daily will help to drive these efforts forward, supporting long-term growth in radiology and improved patient outcomes.

 

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