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Can Innovations with AI Help Address the Impact of Staffing Shortages on Radiology Workflow?
While staffing shortages in radiology continue to persist after the COVID-19 pandemic, current and emerging innovations powered by artificial intelligence (AI) may help facilities navigate these challenges and mitigate rising costs of health care.
We made it through a global emergency a little over four years ago when COVID-19 began its devastating spread across the world affecting billions of lives. The opportunity to move closer to family, to a dream retirement location, or across the country to begin remote employment gained greater acceptance. At the same time, people in high-risk and high burnout jobs such as nursing, radiologic technology, and other medical professions also saw an opportunity to change careers.
People leaving the field was one of a confluence of factors contributing to the increased demand for skilled medical workers. Other factors included increased imaging volume due to COVID-19 and related symptoms, the low number of programs providing opportunity for graduating students not keeping up with demand, and a large number of retiring staff with decades of experience.
Since then, we continue to see a massive shortage among nurses, technologists, and other medical specialists. In fact, one of the most affected professions is in radiology, specifically computed tomography (CT) technologists. While there are always new graduates, the need exceeds the number of those entering the marketplace. Securing a CT technologist position requires a good deal of training in areas such as standard of care and CT-specific procedures, patient care, equipment use, protocols, cross-sectional anatomy, and indications that precipitate ordering a CT.
The downstream effects of staffing shortages in radiology may include: hospitals diverting patients to other facilities due to lack of resources such as no CT technologist to run equipment; existing staff not trained on CT; higher costs to hire a travel technologist; and increased pay/benefits to retain existing staff. (Image courtesy of Adobe Stock.)
The staffing shortage’s downstream effects could be as extreme as: hospitals diverting patients to other facilities due to lack of resources such as no CT technologist to run equipment; existing staff not trained on CT; higher costs to hire a travel technologist; and increased pay/benefits to retain existing staff.
Understanding the Budgetary Impact of the Staffing Shortage
Chief executive officers (CEOs) and chief operating officers (COOs) are well aware of the staffing shortage’s implications on their budgets. They have watched costs balloon up to five times the normal amount when a level one trauma center or an acute care facility providing CT exams hires contract employees that must meet robust certification requirements of these facilities.
A report from Syntellis Performance Solutions found that full-time equivalents (FTEs) for hospital contract employees — from nurses to imaging staff — soared to 138.5 percent.1 Left with little choice to provide staffing, the hospitals and the medical community rely heavily on temporary contract labor which come at a significant expense to hospitals. Compounding this fact, health care staffing agencies increased contract rates to record high levels. The report found that the contract rate increased 56.8 percent in 2022 compared to pre-pandemic levels. This contributed to hospitals’ contract labor expenses increasing a staggering 257.9 percent in 2022 relative to 2019 levels. The explosive growth in contract labor expenses is factored into a combined cost of labor expenses per patient that increased 24.7 percent.1
These increases are particularly challenging as labor accounts for about half of a hospital's budget on average.1
Integrating AI to Bolster Workflow Efficiencies and Clinician Assessments
During this period, more than ever before, innovation and technology was seen as essential tools that were fast tracked to help societies around the world overcome the impact of COVID-19 and are now preparing for the next potential threat. For instance, cutting-edge solutions with computed tomography (CT) systems played a key role in helping clinicians more accurately diagnose and determine more precise treatment pathways for patients through the use of artificial intelligence (AI) technologies.
Canon Medical has invested heavily for decades in technology innovation, fueling image processing advancements and, in the past decade, many AI deep learning reconstruction products. The company has integrated AI into various aspects of its imaging chain from workflow to image quality to automation.
Canon Medical also received positive feedback on integration of AI-driven technology from Marcus Chen, M.D., the director of cardiovascular CT at the National Institutes of Health (NIH), based on initial NIH research of utilizing the AI-driven INSTINX (Canon Medical) user interface in the assessment of CT scans for cardiac patients. The researchers found that employing the INSTINX platform reduced radiology workflow steps by 40 percent for imaging of these patients.
The data analysis provided by AI-powered deep learning techniques like PIQE 1024 Matrix, which is available for cardiac and abdominal imaging on the Aquilion ONE/ INSIGHT Edition (Canon Medical), has made it possible for radiologists and cardiologists to improve Coronary Artery Disease Reporting and Data System (CAD-RADS) assessments. For example, a change in CAD-RADS assessment may lead to a patient receiving statin therapy and no longer being considered as a candidate for diagnostic catheterization.
Recognizing the Capabilities of Telehealth and Enterprise Imaging to Facilitate End-to-End CT Workflow
Just like the migration of thousands of employees in the workforce from the office to working in their homes to help contain the spread of the virus, changes in health care delivery during the pandemic were also necessary. Changes were made to reduce staff exposure to ill people as well as staff who operate the equipment as they reacted to expanding requirements and needs. Staffing shortages have taken a hold in the industry along with ballooning costs while patient care remains the focus.
Remote access can help maintain the patient-provider relationship when an in-person visit is not feasible. Telehealth services can be used for screening patients who may have symptoms of long COVID-19, providing coaching and support for patients managing chronic health conditions, including nutrition and weight management counsel, and for follow up with patients after hospitalization for physical therapy practices and more.
In addition to the benefits of telehealth, enterprise imaging also empowered radiologists to read images at home. The University of Florida (UF) Health Shands Hospital, one of the largest hospitals in the country, utilized technology from Canon Medical to help enable hospital technologists to login remotely and do over the shoulder protocol adjustment for new staff and guide them through the exam with the clinical confidence as if they were on site. As the staffing shortages continued across Florida, the hospital’s radiologic technologists were at the ready to support the new staff, ranging from recent graduates to temporary/contract workers on 13-week assignments, from home, knowing well that a speedy and accurate exam could potentially save a life.
In Conclusion
Challenges from workforce shortages are expected to continue for years. The journey forward will likely be navigated with innovation, AI-driven data simplification and an emphasis on talent retention. Additional solutions by imaging vendors to help address ongoing challenges will come to market with various degrees of focus. While no one can forecast the upcoming election and its ramifications, the radiology industry will brace for a potential slow down while strategizing how to address the potential impact on reimbursement and consolidation.
Staying informed and partnering with equipment manufacturers such as Canon Medical will be critical for radiology departments to thrive in this evolving landscape to reduce costs while retaining staff. Our sincere respect and admiration go out to all of the health-care heroes who have and continue to work so tirelessly to save lives and aid in the care of their patients, their family, and their friends.
References
1. American Hospital Association. The financial stability of America’s hospitals and health systems is at risk as the costs of caring continue to rise. Available at: https://www.aha.org/system/files/media/file/2023/04/Cost-of-Caring-2023-The-Financial-Stability-of-Americas-Hospitals-and-Health-Systems-Is-at-Risk.pdf . Accessed October 4, 2024.
2. 2024 healthcare workforce trends you can’t afford to ignore. Becker’s Hospital Review. Available at: https://www.beckershospitalreview.com/2024-healthcare-workforce-trends-you-can-t-afford-to-ignore . Published November 29, 2023. Accessed October 4, 2024.
3. Glassbeam. Imaging industry trends: a 2023 retrospect and 2024 outlook. Available at: https://www.glassbeam.com/imaging-industry-trends-a-2023-retrospect-and-2024-outlook/ . Accessed October 4, 2024.
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