Securing Radiology’s Future Through the Digital Revolution

“Now more than ever, the radiology community needs to reflect on our culture and practices that seek new clinical and research approaches,” Richard L. Baron, MD, president of the Radiology Society of North America (RSNA), said during the opening session of the 102^nd annual RSNA meeting.

Focused on moving beyond imaging, Baron shared that changes to health care delivery and patient expectations require that all medical professionals continue to evolve and improve.  “Like a pebble dropped onto a pond, our daily practices create a number of ripple effects across the health care landscape and patient experience,” he said.

Focused on the key areas of delivering value: a team approach, continual innovation, and evolved patient focus, Baron said that the changes required for the future are a return to the basics. Instead of focusing on the image alone, radiologists must collaborate with referring physicians to deliver on their needs and earn respect within the medical community.

“Reports should answer key questions and provide solutions,” said Baron. Through personal experience, Baron revealed that when he entered the field, radiologists were known as “renaissance physicians,” commonly sought out by the best specialty clinicians within the hospital for their opinions to help solve their most difficult diagnoses. A return to this type of collaboration is necessary.

Success in today’s health care environment requires radiologists to apply a patient’s personal history, other clinical information, and their own advanced clinical knowledge to reach conclusions that have a greater value to referring physicians. Taking a true team approach by considering ways to reconnect with the rest of the hospital, such as through the relocation of reading rooms, joining morning rounds, or creating more valuable reports, Baron said such practices offer more value in a measurable way to their medical colleagues and their patients.[[{"type":"media","view_mode":"media_crop","fid":"54402","attributes":{"alt":"Richard L. Baron, MD","class":"media-image media-image-right","id":"media_crop_1570385763371","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6811","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 267px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Richard L. Baron, MD","typeof":"foaf:Image"}}]]

Reports must also offer high value and strive to solve a problem and answer a question instead of simply offering findings. “Every report we need to approach in exactly the way you or I would want for our family members,” said Baron who cites Radiology Cares and Imaging 3.0 as valuable resources for radiologists in providing practical steps for quality, patient-centered care that is focused on the entire experience. Also, Baron noted a study presented at the 2008 RSNA which found that radiologists who engaged even minimally with patients by hanging a picture of them next to their images, showed marked improvement in the accuracy of their reports.

Once radiologists establish their value within health care, continual innovations through meaningful research is necessary to compete in today’s market. Creating impactful and broadly visible contributions across all of medicine and science as well as looking more broadly at patient outcomes and community wide impact are two necessary components to success, concluded Baron who said that innovation will drive the future.

Artificial intelligence (AI) or computer deep learning is one such innovation that will play a significant role in health care, according to Keith Dreyer, DO, PhD, vicechairman, radiology, computing and information sciences, Massachusetts General Hospital, who discussed the concept of machine-based thinking. A power that many of us already use on updated smart phones.

“AI will most likely come to radiology first,” he said, acknowledging past technology trends including PACS and Speech Recognition. By creating an artificial neural network that programs computers to “think”, Dreyer predicted, “like all technology, AI will change radiology for better or worse, most likely at the same time.”

The most effective use for AI is one using a Centaur approach where computers and humans work together, Dreyer said.

“To make new radiology, you have to understand our domain, have access to our environments, and have a vision of what radiology is going to look like tomorrow,” Dreyer said, regarding the value radiologists bring to machine learning.

Radiology of the future will be about using machines to make us smarter, do more, and give us more value by giving us more time to communicate, he said.

“Radiology the field, will be the foundation of precision health care,” he said. AI can automate certain aspects of a radiologist’s job that might be tedious, undesirable, and time intensive. Using AI as an augmentation tool instead of an automation tool provides more value, while also offering more efficiency and the opportunity to interact with all clinical data to improve radiologists’ roles as clinicians and advisors.

As the culture of radiology continues to evolve, as new values, technology, and models of care change the way radiologists interact, Baron reminded us all that “the key to our success will be to strive to do what is best for each individual patient at all times and to develop clinically relevant research that focuses on patient outcomes.”  Such individual changes will position all of radiology as a valued resource and indispensable partners in patient care.