5 Things to Watch in 2023
By Dave Yeager
Radiology Today
Vol. 24 No. 1 P. 22

Some Notable Trends from RSNA 2022

After a year in which it drew a little more than 23,000 attendees to its annual meeting, RSNA bounced back in a big way, with nearly 38,000 attendees at the 2022 meeting. Once again, RSNA also offered the conference in a virtual format. The extra traffic produced a noticeable energy boost, making this year’s conference feel a bit more like it did prepandemic. It will be interesting to see whether in-person attendance increases again next year.

The size of the conference always makes covering it a challenge, but it also keeps it interesting. You never know what you might see; this year was no different in that regard. AI is still going strong and seems well on its way to being an accepted piece of the health care puzzle. One thing that struck me this year was that people were talking about it in a more matter-of-fact way rather than trying to draw attention to it.

Below, you’ll find my annual attempt to define five trends that stood out at this year’s conference. With the usual caveat that the following list is not comprehensive and reflects the impressions of a single person, let us begin.

1. Patient-Centered Care
No surprise here, as the theme of this year’s meeting was “Empowering Patients and Partners in Care.” Several plenary sessions dealt with this topic, albeit from different perspectives. In the President’s Address, Bruce Haffty, MD, MS, discussed the growing importance of patient-reported outcomes and patients’ perception of imaging’s value, in light of the health care system shifting from a test-based to an outcome-based model.

In “Doctor as Patient: Imaging Cancer Survival for All,” Elizabeth Morris, MD, talked about the need for empathy and human connection in health care, qualities that were highlighted during her own cancer journey. She also stressed the need for more and earlier screening. Morris emphasized that radiologists need to take a larger role in direct care by being available to explain imaging results, and she believes that, in the not-too-distant future, screening for multiple cancers in an individual will replace screening populations of people for a single cancer.

In “Designing Radiology for Patients, Communities, and the Planet,” Reed A. Omary, MD, MS, described a design-centered approach to patient care. He also discussed the need for more empathy in the health system. By starting with patients and identifying the pain points in the care journey, Omary sees opportunities to improve health equity and patient care. He believes health care can learn from other industries that use technology to not only meet but exceed customer expectations.

In addition to the lectures highlighting patient-centered care, many vendors are making progress in this direction. Several mentioned improving access to imaging and health equity as goals for 2023. Specifically, many are focused on providing access to underserved people, a goal that is increasingly within reach, thanks to technological improvements in making imaging more portable and less costly.

Another point of focus was improving the communication of incidental findings. Inefficient communication systems can hinder the ability of providers to ensure that incidental findings are followed up appropriately. Improving these systems can save lives.

Developing more accurate risk profiles can also save lives. As Siddhartha Mukherjee, MD, said in his lecture, “Three Visions of the Future of Medicine,” diagnostics are not especially useful without therapeutics. Combining the information in genomic profiles with the insights gained from applying AI to medical imaging can aid prevention of many diseases and facilitate early detection of others, leading to more effective treatments.

2. Customer Service and System Upgrades
Discussions about customer service and system upgrades were, well, upgraded this year. Many vendors now offer remote assistance, which can include technological support, troubleshooting, technologist education, and, in some cases, real-time assistance with scanning protocols. Many also offer free software upgrades on a regular basis. Some are offering flexible financing plans to help defray the cost of new equipment.

Several vendors said there’s growing interest in machines that are modular and scalable. With imaging volumes continuing to grow, versatile machines that can be used in a variety of circumstances are increasingly popular. As one person put it, procedures are increasing, but hospitals don’t want more machines.

To help with this need, vendors are implementing nonobsolescence programs to increase the life cycle of existing equipment. Several people I spoke with cited a commitment to servicing machines more promptly by ensuring the availability of parts and qualified technicians.

3. Workflow Efficiency
The downstream effects of workflow, good or bad, can’t be overstated. In the current health care environment, image volumes are increasing significantly faster than the number of new radiologists. Efficient workflows are a necessity. Less-than-optimal workflows cause myriad problems.

One of the problems that is getting the most attention these days is burnout. Many vendors offer solutions that aim to streamline workflow, and one area of emphasis has been on using AI to reduce or eliminate repetitive tasks. This was a theme that came up in several conversations.

While AI was once viewed skeptically and perhaps a little suspiciously, radiologists are much more open to it these days. As many people have pointed out over the years, humans are not especially good at performing repetitive tasks. Any tools that free radiologists to spend more time on tasks that require human insight are welcome. Automating workflow and reducing the number of clicks needed to read a study allows them to spend more time reading images. It also helps to improve practice management, first, by routing studies to the people who specialize in specific types of studies—such as chest or neuroimaging—allowing radiologists to focus on what they do best, and second, by making it harder to cherry pick less challenging studies.

In addition, many vendors are building collaboration tools into their products. Improving communication between radiologists and referring physicians is a core tenet of demonstrating radiology’s value. Providing tools for collaboration helps radiologists demonstrate value and improve patient care.

The emphasis on workflow is not limited to radiologists, however. Vendors are looking at ways to improve efficiency for radiologic technologists. Considering the amount of time that can be saved in the course of a day with small changes to each scan, this approach makes sense for hospitals and imaging facilities. Some of the newer systems allow technologists to work farther from the patient, which speeds up exams and helps with infection control, as well. There is also the matter of ergonomic benefits to optimizing technologists’ workflow. Time lost to repetitive motion injuries affects the entire department.

4. Data Management Tools
There are more data than ever associated with medical imaging. Health care professionals say they’re only able to make use of a fraction of what’s captured. To help radiologists and imaging departments make better use of these ever-increasing information volumes, many companies are offering analytics-based tools.

A growing number of tools assist radiologists with their reads. Many AI companies offer decision support algorithms that can identify specific medical conditions, alerting radiologists to important findings. Other tools help to stratify risk, helping physicians plan treatment or, in some cases, modify it. Analytics are also crucial for monitoring machine use and workflow to provide insight for administrators and department managers.

Data is also key for developing algorithms and conducting research. One challenge associated with these tasks is deidentifying data. Another is managing data from multiple institutions. Some of the people I spoke with at RSNA are working on data deidentification and management for these purposes.

5. Use of the Cloud
In the past few years, use of cloud computing to store and manage data has grown rapidly. For many hospitals and imaging facilities, imaging volumes now make it more of a necessity than a luxury. Cybersecurity is also a significant concern, and many people would rather hire an expert to manage their data security than do it themselves. To meet demand, many vendors are now partnering with Google and/ or Amazon and/or Microsoft to increase their cloud capability.

Dave Yeager is the editor of Radiology Today.