Dispatches December 2017

News from the ACR and beyonddispatches


Cincinnati Radiologists Give Patients Direct Imaging Exam Results

david mihal Patients and their families are often nervous about their imaging exams, and, for some, uncertainty about how to obtain their imaging results increases their anxiety. So David C. Mihal, MD, diagnostic radiology resident at the University of Cincinnati Medical Center, started working with Diane Hater, patient and family advocate in Cincinnati Children's Hospital and Medical Center's radiology department, to foster meaningful and positive change in patient anddiane hater radiology relations. The outcome: a direct results-delivery pilot project that allows patients and families to review their exam results directly with a radiologist immediately after images were obtained. Since the pilot began in 2015, it has drawn praise of patients and families — with 92 percent providing positive feedback on surveys — and has led to 84 percent of participating radiologists and technologists reporting increased job satisfaction. The department has adopted it now as an ongoing initiative.

Read more in the Imaging 3.0® case study, Behind the Curtain, at bit.ly/Cinci_Study.

Seeking New JACR Editor in Chief

The JACR® is seeking a new Editor in Chief. The Editor in Chief has editorial responsibility for the JACR and maintains the scientific quality of the journal. The JACR's four focus areas are health research and policy, clinical practice management, training and education, and leadership. The Editor in Chief will prioritize diversity in content, authors, and the composition of the Editorial Board. Applications are due by Dec. 31, 2017.

For more information, visit www.acr.org/eic.

New CME with CPI

The Continuous Professional Improvement (CPI) program has renewed four popular CPI modules originally published in 2013 and 2014: Genitourinary Tract, Emergency Imaging, Musculoskeletal, and Pediatric. Earn up to 8 CME and 8 SA-CME per module. Choose between the print publication or the online exam and enjoy a free e-book download.

Visit www.acr.org/cpi for more information.

Coordinators Could Free Up Time, Head Off Burnout

head off in burnoutRadiologists have a new weapon against burnout and a way to boost their overall job satisfaction, says a recent case study in the JACR®. A comprehensive reading room coordinator service could improve radiologists' workflow efficiency, study authors said. Coordinators would help radiologists reach referring physicians throughout the day, for example, or connect them with IT staff to resolve issues. "Radiologists practice in busy environments, with ever-increasing clinical volumes, as well as pressures to perform a growing array of noninterpretive, value-added activities, such as consultations or provider-driven customized reporting," said lead author Andrew B. Rosenkrantz, MD, MPA, department of radiology at NYU Langone Medical Center in New York City, and colleagues. "Enlisting ancillary personnel to assist radiologists in phone calls and other administrative tasks may provide the kind of support needed" to avoid radiologist burnout.

For more visit bit.ly/Room_Coordinator.

FDA Advisory Group Adds Gadolinium Warning Labels

The U.S. Food and Drug Administration will revise its prescribing information for gadolinium contrast agents used during MRIs to include a warning label about possible retention of the substance by certain organs and tissues. The Agency's Medical Imaging Drugs Advisory Committee voted to add the labels, amounting to a warning that minute traces of gadolinium may occur in slightly greater amounts in some uses of the contrast agent and recommending ways to reduce retention of it in patients who may be at greater risk.

Read more at bit.ly/FDA_Gad.

Radiologists Aren't Comfy in the Reading Room

Musculoskeletal discomfort has been reported by a majority of radiologists, is significantly influenced by age and gender, and occurs more often for radiologists than with more mobile peers, according to a recent JACR® study. Radiology trainees at Emory University were sent the Cornell Musculoskeletal Discomfort Questionnaire to evaluate musculoskeletal pain and discomfort as a result of time spent at their workstations in reading rooms. "Our findings suggest the need to educate radiologists regarding the adverse health effects of prolonged sitting, and encourage them to incorporate movement breaks and periods of standing into their workday," the study authors wrote. Most who responded to the survey indicated that they spent more than seven hours a day at a diagnostic workstation — an amount of time that aligned with higher total pain scores. The report noted that more investigation into the discomfort levels of radiologists is needed to identify interventions that could alleviate symptoms.
See the study at bit.ly/Reading_Agony.

It's Almost Time to Renew Your Annual Pledge To Radiation Safety

Image Wisely® is a joint program of ACR, RSNA, AAPM, and ASRT that provides current information and guidelines on radiation safety with the objective of lowering the amount of radiation used in medically necessary imaging studies and eliminating unnecessary procedures. It's almost time to renew your annual pledge to optimize radiation dose in your medical imaging.

Visit imagewisely.org beginning Jan. 1 to renew your pledge.

Last Chance to Submit Abstracts

The deadline to submit an abstract for the ACR 2018 Annual Meeting is Dec. 15! Don't miss this unique opportunity to share your last chanceoriginal research with top leaders in academia and private practice. Accepted ePosters will be displayed during the meeting, and those who submit high-quality abstracts may be invited to give a short presentation. Travel awards will be granted to the top abstracts in each category.

Visit www.acr.org/callforabstracts to view criteria and submit your abstract.

Exposure to IR Popular Among First-Year Med Students

Introducing IR lectures as part of gross anatomy courses improved medical students' understanding of the material, according to an article published in the Journal of Vascular and Interventional Radiology. Researchers at the University of Pennsylvania Perelman School of Medicine noted, "The integration of IR education into the first-year anatomy course is a highly effective way of increasing first-year medical student exposures to IR and generating interest in the field." Hands-on workshops were added following the initial lectures, allowing students to observe IR techniques and procedures. Researchers said, "Additional studies regarding effective ways to teach medical students will provide IR educators with evidence as they pursue educational initiatives within medical-school curricula and work to recruit the best and brightest students into the specialty."
Read more at bit.ly/IR_Intro.

AI Tackles Bone Age Reads

bone age readRadiologists trying to estimate a patient's age using radiography might find their jobs a little easier with an AI tool that analyzes skeletal radiographs, according to an article in the American Journal of Roentgenology. Korean researchers created a deep-learning algorithm to produce bone age estimates. The algorithm served as a second reader of images in daily clinical practice testing.
Bone age estimation is used to determine development patterns in pediatric patients, among other things, and researchers wrote that their software "showed reliably accurate bone age estimations and appeared to enhance efficiency by reducing reading times without compromising diagnostic accuracy." They noted that the process of estimating bone age can be burdensome to radiologists because of its repetitive nature and the amount of time involved. They added that the accuracy depends on a radiologist's experience and tends to be subjective.

Read more at bit.ly/AI_Bone.

Here's What You Missed

The Bulletin website is home to a wealth of content not featured in print. Check out blog posts, extra articles, and other multimedia content at acrbulletin.org.

The Corporate Practice of Medicine

The ACR Legal Office receives occasional inquiries regarding the corporate practice of medicine. Most often, radiologists are trying to ensure that high-quality radiology is practiced in their community. Read more about what radiologists need to understand about corporate entities and radiology at bit.ly/Corp_Med.

How Much Does It Cost?

A general lack of awareness of the price of imaging is keeping patients from making informed decisions about their health. Shared decision-making is a term applied to communication between a physician and patient — in which the physician knows the medical aspects and the patient knows his or her own lifestyle and treatment preferences. One aspect of shared decision-making that's sorely lacking in the conversation is cost. Read more at bit.ly/Image_Costs.

ACR Members Urged to Voice Concerns Over Anthem's Outpatient Imaging Policy

The ACR has created an online mechanism to collect reports from patients, members and facilities in states impacted by Anthem's new outpatient imaging policy. Anthem is singularly removing diagnostic imaging from the continuum of patients' health care services and treating vital, life-saving radiology care as a commodity going to the lowest-priced provider. ACR believes that policies that treat diagnostic imaging separate from the accepted continuum of health care are anathema to the profession's central role in diagnosing and treating patients. Moreover, a proliferation of such prior authorization policies focused on site-of-service issues could turn medical imaging reimbursement into a race to the bottom with significant consequences for all imaging providers, regardless of practice setting. In its aggressive maneuvers to coerce hospitals to accept price reductions, Anthem is treating patients and ordering physicians as pawns entangled in its negotiating tactics. To see the specifics of Anthem's policies related to outpatient imaging, go to bit.ly/Anthem_Policy. To view exceptions to the policy, visit bit.ly/Anthem_Exceptions. Share your Anthem experience at bit.ly/Share_Experience.


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