In Case You Missed It

ACR 2017: Sunday, May, 21  

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ACR 2017 started off with a bang. Here are the goings-on from day one of the conference.

Presidential Address: Ahead of the Curve

BibbAllenBibb Allen Jr., MD, FACR began his address with a simple goal for the specialty: to stay ahead of the curve. But this common phrase probably doesn’t mean what you think, said Allen. The saying likely originated in the aviation industry, where pilots seek to reach and stay within what is called the power curve (the airspeed at which an airplane is most efficient). A pilot flying behind the curve risks stalling and has limited options in case of trouble. On the other hand, an aircraft flying ahead of the curve is much more efficient and adaptable.

“In radiology organizations and in our practices, we have to be conscious of our environment and proactive in our thinking and actions or we will surely fall behind the curve,” said Allen. To further complicate matters, what it means to stay ahead of the curve is continually changing. “We now recognize that in order to be more relevant and valuable to our patients, radiologists must also be able to partner with their health systems and referring physicians to provide cohesive team-based care,” he said. “The ACR is committed to being your partner in demonstrating the value you are providing every day in your practices to CMS, our health systems and the public.” Tools like Qualified Clinical Data Registries are designed to support practices of all sizes in meeting CMS reporting requirement.

Another measure to keep radiology and its patients ahead of the curve is the ACR’s clinical decision support tool, ACR Select®. “Why would radiologists and our national organizations support tools that might decrease the volume of what we do?” asked Allen rhetorically. “The ACR placed a flag in the sand saying that radiologists can and will lead physicians in the appropriate use of diagnostic imaging studies.” For nearly 25 years, the ACR has created and continually updated the Appropriateness Criteria® (AC) to support clinicians in ordering the most appropriate imaging for a given clinical condition. “And as technology caught up with our desire to deliver clinical decision support to the point of care, our ACR AC through ACR Select are now integrated into the electronic health record systems of all of the major vendors,” said Allen.

The Imaging 3.0® initiative focuses on the culture of radiology and radiologists providing value beyond imaging interpretation. And as radiologists eye the future of artificial intelligence (AI), never has it been more important to provide this value to patients, referring clinicians, and health systems. Allen pointed to the ACR’s new Data Science Institute as the College’s vehicle to influence the future of AI in health care. “We should never characterize the introduction of artificial intelligence into radiological practice as machines versus radiologists, but rather as radiologists working with machines to add artificial intelligence algorithms to our armamentarium that will be benefit our patients more than radiologists alone and much more than machines instead of radiologists,” he said.

Convocation: Welcoming This Year’s New Fellows

Convocation 2017

Each year, the College recognizes individuals who stand above the rest — their work supports quality patient care and advances the specialty. Over 100 recipients don their caps, gowns, and colors representing their medical schools. Brimming with pride, they march down the aisles against a backdrop of excited friends, family, and colleagues who watch them receive recognition of their ACR Fellowship. In addition to the fellows, the celebration honors the 2017 ACR Distinguished Achievement Award Recipient, Honorary Fellows, and ACR Gold Medalists.

Receiving the ACR's third Distinguished Achievement Award is Pamela A. Wilcox, RN, MBA, who served the College for 28 years. Her efforts on behalf of quality and safety have helped transform mammography and develop other ACR accreditation programs. Such transformations required intimate collaboration with organizations including the American Cancer Society, the American Medical Association (AMA), and the Food and Drug Administration. Wilcox detailed her time at the College, including the long battle for screening mammography. “[The battles] were often bloody,” she said, “but the breast imagers always stood their ground, and I was proud to be part of that team.”

Honorary fellows Berend Slotman, MD, PhD, of the Netherlands, and Jacob Sosna, MD, of Israel, expressed gratitude for receiving the award. Both spoke of the past and of the future. Slotman said he believed “the best is yet to come” for the imaging community, noting how new treatments such as MR-guided and adaptive radiotherapy would “lead to more cures and less toxicity and bring radiology and radiation oncology closer together.” Sosna spoke of Israel’s rich history with imaging, including its affiliation with the first portable x-rays during World War I. Sosna also praised radiology’s role in patient care, saying that he “chose radiology because it encompasses knowledge of all aspects of medicine."

The ACR Gold Medalists also expressed gratitude and gave valuable advice for radiologists of the future. Bruce J. Hillman, MD, FACR, extensively thanked his colleagues, family, ACR volunteers, and staff, saying, “It is almost unfair for one individual to be so thoroughly blessed.” Hillman also explored the Jewish prayer Dayenu, spoken during Passover. “Dayenu” means “It would have been enough,” said Hillman. The prayer expresses gratitude for all blessings, noting that if just one of those blessings had occurred, it would be enough for the individual. Hillman thanked each person who had helped him during his career, noting that each of these contributions would have been enough for a long and satisfying career.

Gold Medalist John A. Patti, MD, FACR, also thanked the College and his colleagues. He said, “The ACR brings people together who might otherwise have never known each other and with whom lifelong friendships are made.” His parting advice for the new fellows was to continue the outstanding work they were doing, and for residents to “get involved early...and make service to your profession a part of your daily life.”

Like the other medalists, Jeffrey C. Weinreb, MD, FACR, thanked those who had been a part of his life, particularly his family. He said, “When I think about how it is I came to stand in front of you this evening...my thoughts inevitably turn to my parents, first-generation Americans from the Bronx who bequeathed to their progeny a strong work ethic, a good set of genes, and the tradition of our people to heal the world.” Weinreb also had parting advice for the new fellows and residents. He quoted the comedian Professor Irwin Corey: “"If we don't change direction soon, we'll end up where we're going."

Keynote Address: Pivot and Go

Jeff ImmeltIn a flipped format, the keynote address took the form of an engaging Q&A between Jeffrey R. Immelt, GE chairman and CEO, and chair of the ACR BOC James A. Brink, MD, FACR. Immelt has been named one of the World's Best CEOs three times by Barron's, and since he began serving as chief executive officer, GE has been named America's Most Admired Company in a poll conducted by Fortune magazine and one of the World's Most Respected Companies in polls by Barron's and the Financial Times. GE recently moved its corporate headquarters to Boston, giving MGH’s Brink and Immelt common ground as they explored the connections between GE as a corporate entity and a health care business and the profession of radiology as they both navigate changing times.

Referencing GE’s divestment of its financing business and its focus on data-driven technology advances, Immelt described GE’s updated business model as “narrower and deeper” than had previously been the case at the company. “We always want to be on the technical edge of whatever industry we’re in,” he said, and advised radiologists to pinpoint the value they bring to patients and the care process with an emphasis on reduced variability and process improvement enabled by imaging data.  One way GE stays on that leading edge is by seeking out a variety of perspectives. “You’re in a sea of ideas, particularly around health care,” said Immelt. Rather than be overwhelmed by so much information, he suggested being proactive about listening to and incorporating disparate viewpoints. “Don’t get too internally focused,” he added.

Thriving in a time of constant change, particularly around artificial intelligence (AI), was a thread running throughout the conversation. “When I think about AI for radiology, our customers, and GE, we now have a new tool that is going to make everyone in this room better,” Immelt said. He views this technology as an opportunity. “Don’t fear it,” he advised. Immelt emphasized the importance of radiology’s input in shaping AI in health care. “Somebody is going to do it,” he said. “Why not you?”

To stay relevant, Immelt advised radiologists to continually upgrade their skillsets. “You need to not just be resilient, but pivot,” he said. “You just pivot and go.”

Asked what the professional and the corporate world could do to improve care, Immelt quickly answered, “Improve the ability to collaborate together more effectively.”

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