The official theme of the 103rd Scientific Assembly and Annual Meeting of the Radiological Society of North America, held at Chicago’s McCormick Place, was “Explore. Invent. Transform.” The unofficial theme could have been either, “Make Artificial Intelligence Your Friend, Not Your Enemy” or “Radiologists Must Do More to Demonstrate the Value They Provide to Patients and Payers.”
Though clearly not as pithy and certainly wordier, the alternative themes are accurate nonetheless.
To the more than 48,000 attendees at RSNA this year, it was clear that artificial intelligence and value-based care were the dominant themes coursing through every exhibit hall, educational session, poster presentation, plenary address, and branded lecture during the six-day event.
Conference kicked off with call for recognition of the cost of new imaging technologies
RSNA President Richard Ehman, M.D., foreshadowed the theme of value-based care in an interview with the RSNA Daily Bulletin and again in his opening session address, “Is It Time to Reinvent Radiology?”
“In medical imaging, the value of a diagnostic procedure can be considered to be proportional to metrics for diagnostic performance, quality, safety and service, and inversely related to cost,” Dr. Ehman said. “Extraordinary innovations in medical imaging science and technology have steadily advanced value by escalating the diagnostic performance of our services, but perhaps we have not applied the level of creativity and innovation to minimizing cost in the denominator of the value equation.”
In other words, the cost of new imaging technology should be considered along with its capabilities.
Imaging without the images may be in radiology’s future
Almost as if to prove Dr. Ehman’s point, capabilities, not cost, was the focus of the plenary session on day two of the conference. The title of the New Horizons Lecture, given by Daniel Sodickson, M.D., was “A New Light: The Birth, and Rebirth, of Imaging.”
Dr. Sodickson, a radiology professor at NYU Langone Health in New York, described radiologists as the ultimate “explorers of inner space” who soon will be evaluating imaging test results with their brains instead of their eyes because of the advances in artificial intelligence and machine learning.
Dr. Sodickson described a future in which patients receive a “continuous comprehensive” scan that “captures everything all the time,” from the moment the radiologist hits the green button until the patient leaves the exam room. Artificial intelligence can convert the data into information for the radiologist and eliminate the need to create images during the imaging process. In this scenario, radiologists no longer read and interpret images but become what Dr. Sodickson labeled “information innovators.”
Anxiety over artificial intelligence generates a big crowd
Attendance at the following morning’s two major presentations on artificial intelligence suggested that Dr. Sodickson’s predictions raised the already high anxiety level of radiologists who fear being replaced by computers. More than 500 attendees crowded the presentations by Keith Dreyer, D.O., and Antonio Criminisi, with RSNA staff leading another 100 attendees to another conference room to listen to a live stream of their talks and watch their slide presentations on a separate screen.
Dr. Dreyer, who is vice president of radiology at Massachusetts General Hospital in Boston, spoke on “Harnessing Artificial Intelligence.” Criminisi, principal medical AI researcher for Microsoft, spoke on “Assistive AI for Cancer Treatment.”
Dreyer said the health care industry “needs a factory approach” to accelerate the development, adoption and use of artificial intelligence in medicine. Massachusetts General itself is working on 44 different AI applications, he said. Criminisi jokingly said radiologists should stop worrying about being replaced by artificial intelligence, because AI ultimately will replace all of humankind. He did try to allay any fears by ending his talk with the prediction that artificial intelligence won’t replace anyone and instead will only “amplify the skills of medical experts.”
Time running short on radiologists to deliver on value proposition
Later that day, Jonathan Kruskal, M.D., gave perhaps the most honest, animated, and technically sophisticated talk of the conference. Dr. Kruskal, radiology department chairman at Beth Israel Deaconess Medical Center in Boston, gave the Annual Oration in Diagnostic Radiology during the afternoon plenary session. His topic was “Strategies for Radiology to Thrive in the Value Era.”
Dr. Kruskal raced through anecdote after anecdote—complete with animated visuals—of less-than-valuable services provided by radiologists to patients, health plans and referring physicians. He said the No. 1 reason radiologists struggle to provide value to their customers is that “they don’t really know what value is.” As he affectionately chided his own profession, Dr. Kruskal displayed attendees’ real-time reactions to his talk via Twitter.
Dr. Kruskal identified four attributes of value that radiologists should embrace—quality, outcomes, experience and costs—and eight strategies they should pursue to deliver on those attributes:
- Provide appropriate and efficient care
- Deliver excellent service
- Be data-driven
- Be visible to patients and other physicians
- Be available and accessible
- Learn and improve continuously
- Deliver unambiguous imaging reports
- Engage all customers and stakeholders
The time has come, Dr. Kruskal said, for radiologists to “walk the value talk.”
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