RSNA 2013: Tracking Trends & Building Partnerships

As 2013 winds down, it’s time to gear up for the 99th Scientific Assembly & Annual Meeting of the Radiological Society of North America. As always, Health Imaging will be your guide to the biggest conference in radiology.

RSNA returns to McCormick Place in Chicago on Sunday, Dec. 1, through Friday, Dec. 6, and the schedule will once again be packed. More than 50,000 attendees from around the world will have their choice of approximately 3,000 scientific presentations and posters covering the latest research, trends and practices in radiology.

This year’s theme “The Power of Partnership” underscores how essential coordination will be for the continued success of radiology. Traditionally seen as “the doctor’s doctor,” the role of radiologists is shifting. More and more, they are being asked to step out of the reading room and connect directly with patients, physicians and clinicians. The evolution of informatics technologies is helping imaging specialists partner with clinicians in new and exciting ways. Radiology groups also are actively marketing to their communities the value of radiologists in care decision-making.

Policy and reform issues also loom large, making a case for more concrete partnerships with government, industry and payers. “The biggest story in all of medicine…and radiology is no exception, is the Affordable Care Act (ACA) and its implementation,” says Ross A. Abrams, MD, of Rush University Medical Center in Chicago. While he says he believes affordable care brings many positive changes—extending affordable healthcare options for those that were uncovered, restricting payers from denying coverage for pre-existing conditions—from the perspective of providers, any policy overhaul has important financial implications.

This brave new world of reform is reflected in the session topics at this year’s meeting. More time will be spent on economics and policy. Of course, there also will be plenty of scientific presentations highlighting the leading edge of research. Health Imaging spoke with members of several RSNA planning committees to get their take on the biggest trends at RSNA 2013, and our editorial team is offering our recommendations for can’t-miss sessions. We also check in with RSNA President Sarah S. Donaldson, MD, to talk about the partnerships she says are essential.

Economics, Policy & Practice

Much of the discussion around policy and practice management over the last year has revolved around the continued rollout of accountable care organizations and the fallout from sequestration cuts. These issues have been a few years in coming, but are now beginning to feel more tangible, says Dean Shibata, MD, of the University of Washington, in Seattle, and chair of the RSNA educational exhibits for policy and practice.

“These are things that everyone hears about on the news, but I think many of us in radiology have been trying for the most part to ignore it and hope the effects will be benign and minimal,” he says. “But it’s turning out that we’re seeing decreased reimbursement from Medicare and we’re realizing that some of these concepts like sequestration, may start having a direct impact on our practice.”

As a reflection of this, RSNA 2013 is featuring a section of sessions on economics in addition to the standard scientific and practice management sections. There also will be a growing focus on partnerships with patients and clinical colleagues.

“That’s a theme and part of this whole change [in the economics of radiology]. Radiologists can no longer be isolated from patient care and will need to partner more with the patients we’re providing services and with the clinicians we’re providing services for,” says Shibata.

suggested sessions:

• The Future of Radiology: What Are the Threats and How to Respond to Them — Sun., Dec. 1, 2:00-3:30 pm
• Changing Role of Radiology in the U.S. Health Care System — Mon., Dec. 2, 8:30-10:00 am

Informatics

Two promising technologies of years past—tablet computers and clinical decision support—will again be a major focus at RSNA 2013, but this time as proven tools that have demonstrated their ability to aid the practice of radiology, according to the chair of the informatics committee, David Hirschorn, MD, of Staten Island University Hospital in New York and Massachusetts General Hospital in Boston.

Studies have shown that the tablet computer, with the right ambient light and software, can be used as an imaging platform to achieve reasonable diagnostic results, with the obvious added benefit of increased mobility.

Clinical decision support also is gaining acceptance, with more EHR vendors trying to put such systems into practice, says Hirschorn. Until now, informatics has been about serving the request of referring physicians and getting them their reports, but Hirschorn notes that clinical decision support is a way for radiology to step outside itself and get more involved in the ordering process.

The evolution of informatics has had to walk a fine line; radiologists don’t want to step on the toes of referring physicians, and at the same time, some imaging specialists have worried that new technologies are leading to the commoditization of the profession. However, Hirschorn argues that advances in clinical decision support and robust image sharing platforms, such as RSNA’s Image Share network, are actually a way to make radiology more relevant and valuable.

“Technology itself is neither a good thing nor a bad thing. It’s a tool, an instrument…it depends on how you use it,” he says. “You can take these technologies to build bridges, to build partnerships.”

suggested sessions:

• Meaningful Use for Radiology IT Vendors: What Your Customers will Demand, and Your Competition will Provide — Mon., Dec. 2, 4:30-6:00 pm
• Effect of Computerized Evidence-based Clinical Decision Support (CDS) on the Use and Yield of Computed Tomography Pulmonary Angiography (CTPA) in the Inpatient Setting — Mon., Dec. 2, 10:30 am-12:00 pm
• Informatics (Image Sharing) — Wed., Dec. 4, 3:00-4:00 pm

Molecular Imaging

Molecular imaging is at a turning point. Perhaps more widely thought of for its applications in cancer imaging, molecular imaging modalities are increasingly being researched for use in examining multiple sclerosis, traumatic brain injury, dementia and Alzheimer’s disease and other neurodegenerative disorders.

The techniques and technologies of this subspecialty also are gradually making the move from the research phase to clinical practice, which requires the coordination of experts in a number of fields, says Satoshi Minoshima, MD, PhD, of the University of Washington, Seattle, and member of the molecular imaging committee at RSNA.

“One of the emphases at RSNA is translational research, which is really the partnership between basic scientists and engineers and clinical scientists,” he says. “Affordable molecular imaging technology which will provide critical information for patient care, that’s definitely the goal for molecular imaging development.”

Trainees and younger faculty members at RSNA will be invited to participate in the Molecular Imaging Case of the Day initiative, which will provide a glimpse at the clinical use of molecular imaging. It also will be the second year of the Molecular Imaging and Nuclear Medicine campus, an exhibit area returning after a successful debut in 2012, says Minoshima.

suggested sessions:

• PET-MRI in Alzheimer’s Disease — Mon., Dec. 2, 12:15-12:45 pm

Oncology

Approximately 14 million people living in the U.S. have had cancer and more than 1.6 million new cases are diagnosed each year. According to a recent Institute of Medicine report, however, the cancer care system is in crisis due to increasing costs and complexity of treatment and a shrinking workforce. Care also can fail to be patient-centered or based on the latest evidence.

Due to the complexity of the disease and the many forms it takes, no single specialty will be able to tackle cancer alone, says Ross A. Abrams, MD, of Rush University Medical Center in Chicago and member of the oncology committee.

“[Excellent cancer care] is dependent on the thoughtful, coordinated and integrated input of multiple specialists in the appropriate combinations and sequencing. As a radiation oncologist, in terms of patient management, it’s always about partnerships,” says Abrams.

Many radiation oncology practices are institutionally-centered as opposed to physician-owned adding another layer of coordination, as oncologists must meet the needs of patients while responding to the financial needs of a larger institution. The Affordable Care Act demands that care gets better and cost less, says Abrams. “That makes the experience more challenging, but it doesn’t change the essential nature of what we’re supposed to be doing all along.”

suggested sessions:

• Breast Imaging (Screening & Density) — Tues., Dec. 3, 3:00-4:00 pm