2018 will bring an advanced pace to the digital transformation of the healthcare industry. Changing consumer preferences, provider consolidation, and tech titans like Apple, Amazon and Microsoft moving into the space will be major market forces fundamentally changing the way patient care is managed and delivered. While the regulatory uncertainty for payers, providers, and pharmaceuticals remains in 2018, value-based care will continue to be a top priority. Will 2018 be the year where we’re diagnosed by a virtual AI doctor from our smartphones? Probably not, but here’s what we think will unfold in the year ahead. Stay tuned for an infographic featured at the bottom of this post.
Why shouldn’t moving imaging across healthcare providers work like the ATM network of banks today?Medical imaging is more spread out than ever before across a geographically distributed and diverse referral and patient community. According to a recent survey by Ambra Health< of over 1,000 healthcare consumers, referrals are still the primary way patients find a new physician. This means an enhanced emphasis on image ordering efficiency, turnaround time, quality of reads, and most importantly, referring provider satisfaction as imaging needs to move efficiently across a patient’s extended circle of care. This landscape will drive increased interoperability across providers and open referral networks will emerge as competitive differentiators for regional centers of excellence.
Google, Amazon, Apple, and Microsoft continue their advance on the healthcare industry in various ways from venture funding, research, infrastructure, to applications, and practitioners are taking note, including Jefferson Radiology CTO Mike Quinn who highlighted the emergence of the “big 4” in healthcare as a trend to watch in 2018.The race is on to see which business will dominate health data storage, including imaging data. For the first time, Google attended the annual Radiological Society of North America (RSNA) conference and announced a number of collaborations with medical imaging providers including Ambra Health.
Providers are looking to Vendor Neutral Archives (VNA) and the scalability of the cloud to create a centralized store for physician productivity and care. Dr. Keith Hentel Executive Vice Chairman Department of Radiology, Weill Cornell Medicine sees cloud VNA as a powerful way to create a unified environment, with more complete access to data for physicians.Dr. Hentel says, “Our physicians want to see the compendium of multimedia on a patient in one unified environment. We’re going to be investing a lot in our VNA, to help combine radiological imaging data with, perhaps, dermatological, or endoscopic data, and their EKG’s.”
There is much talk about how AI will radically transform health care, using big data – our data – to find new cures and insights. But for all the excitement comes critical issues surrounding data use and ownership. What is the right regulatory balance that maximizes positive patient outcomes? How can we, as patients, understand our rights and what happens to our data in this brave new world? Healthcare consumers will take an active role in questioning how our data is being used to be able to make informed decisions about that use.
With the changing face of regulations like MACRA, MIPS, and PAMA, value-based healthcare models continue to rise over fee-for-service. Dr. Krishna Juluru, Director Imaging Informatics, Memorial Sloan Kettering Cancer Center says that informatics has become a key area at the center of excellence, and he knows, “to the last hour or so how many scans are being done, what facilities within Memorial those scans are being performed, what body parts are involved, what subspecialties are involved, and more.” Their current initiative focuses on expanding measurements by analyzing referral patterns to ensure they are providing strong referring physician and patient service.
The 21st century healthcare consumer is already comfortable with cloud and mobile technology, so they’re making decisions based upon how well practices and hospitals are using these digital tools to meet their needs. However, providers have been typically slow to change. A recent survey by Ambra Health of over 1,000 US adults showed that it still takes 44% of patients over a day to have imaging sent to a physician, and most of that transfer is still occurring through CDs. Facilities must understand imaging consumer preferences, which frequently include items like an image-enabled patient portal, “family share” plans, mobile access and more.
Data security continues to be a major factor as healthcare systems move to centralized cloud storage facilities. With security technology, talent, and awareness improving across all industries, security tactics will shift with the help of AI and machine learning from reactive protective measures to proactive preventative ones. Data security teams with the help of machine learning and AI will have an increasingly important role for predicting security infringements before they happen.
The latest machine learning, deep learning, and workflow automation technology can accelerate interpretation, improve accuracy, and reduce repetition for radiologists and other specialties. During the annual RSNA conference in November, AI was by far the most talked about trend for 2018 – on both ends of the spectrum. Many practitioners are excited about its potential to transform everyday workflows while others are skeptical that AI’s moment has arrived. There are certainly many potential use cases for AI workflow improvements in radiology. One example is to use algorithms to automatically align current and prior exams for instant comparison of multiple studies. Machine learning, when combined with artificial intelligence, can even further improve processes by scanning imaging. The rise of AI applied to workflows will be uneven in 2018 – with health systems who have the infrastructure in place already off to the races.
Mobile health clinics have been active in communities for quite some time. However, 2018 will usher in a new level of sophistication for these services. According to Mobile Health Map’s latest impact report, there are approximately 2,000 clinics on wheels across the country providing services including primary care, preventative screening, disease management, behavioral health, dental care, pre-natal care, and pediatric care. Extremely cost efficient and effective at reaching underserved and vulnerable communities, mobile clinics with enhanced technology capabilities will further extend the spectrum of services. For example, earlier this year the Barrow Neurological Institute in Phoenix, AZ unveiled a fully equipped mobile stroke unit which enables the medical team to evaluate, diagnose, and even start treatment before the patient arrives at the hospital. The specialized truck carries equipment such as mobile CT scans that ambulances do not currently provide.
With the rise of organizations such as RADxx supporting the advancement of women in radiology, the issue of diversity in the practice has come front and center this past year. Evolving consumer healthcare preferences mean radiologists are increasingly taking on more patient-facing responsibilities. With that shift comes the need for radiologists to represent the diverse populations they serve. In a recent Radiology Business article, Tessa S. Cook, MD, PhD, assistant professor of radiology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia noted the change, “patient and family-centered care is a very personal, a very non-technical interaction that all of us as radiologists are increasingly being challenged to do more of.”