News from the ACR and Beyond

Jan Carousel images 07 07(Left to right) Sagine Berry-Tony, MD, demonstrates an ultrasoundguided biopsy procedure to Nikka Jones and Kelara Samuel.

Inspiring the Next Generation

On Oct. 23, 2018, ACR hosted its first solo radiology/ radiation oncology workshop at a medical school. Carolyn C. Meltzer, MD, FACR, and Derek L. West, MD, MS, of Emory University, provided Morehouse
School of Medicine students with an overview of radiology by highlighting subspecialties and modalities. Sagine Berry-Tony, MD, Pallavi Nadendla, MD, and Shreyas R. Patel, MD, of Emory’s department of
radiology and imaging sciences, provided hands-on procedural demonstrations for the students.
Learn more about the ACR’s outreach to medical students at acr.org/MedicalStudent.

CMS Releases QPP and MPFS Final Rules

CMS released the 2019 Quality Payment Program (QPP) final rule and the 2019 Medicare Physician Fee Schedule (MPFS) final rule in early November. In the QPP final rule, CMS described changes to policies for implementation of the third year for the Merit-Based Incentive Payment System and for Advanced Alternative Payment Models expansion of the Cost category to 15 percent, required use of the 2015 Comprehensive Error Rate Testing, and the implementation of facilitybased measures. The MPFS final rule further clarified the two-phase rollout of required clinical decision support use previously mandated by PAMA. It dictated that referring providers must consult Appropriate Use Criteria prior to ordering advanced medical imaging for Medicare patients beginning Jan. 1, 2020.
For a summary of the final rule, visit acr.org/MPFSFinalRule_Summary.

It’s Time to Apply for the FACR

Interested in becoming an ACR Fellow? It’s time to complete and submit your application. Being selected as a fellow is one of the most prestigious honors bestowed upon long-time ACR members and recognizes exceptional achievements in the fields of radiology, radiation oncology, or medical physics. Fellows have distinguished themselves through lifelong service to the College, organized radiology, medicine, research, and/or teaching. Physicians and medical physicists with at least 10 consecutive years of membership may apply now for 2020 fellowship. New fellows are inducted during the convocation ceremony at the ACR Annual Meeting in May.
Visit acr.org/facr for your chapter’s deadline.

ACR Names New EVP of Center for Research and Innovation

The ACR has named Charles K. Apgar, MBA, as executive vice president of the ACR Center for Research and Innovation™. Previously the chief operations director of the center, Apgar has supervised operations and strategy for many landmark clinical trials during his 15 years with ACR — including the National Lung Screening Trial and the Digital Mammography Screening Trial, as well as the National Oncologic PET Registry. “Charles has been a central figure in the management and direction of large-scale radiology clinical research for more than a decade,” says William T. Thorwarth, Jr., MD, FACR, ACR CEO. “His expertise and experience has helped make the Center for Research and Innovation the force that it is. We look forward to many more years of his effective leadership as EVP.”

To read more, visit acr.org/CRIEVP-Apgar.

Imaging 3.0 Debuts Adaptable Presentations

The practice of radiology is transitioning from volume-based to value-based imaging care. One way ACR members are working to ensure the future viability of the field is by sharing knowledge and best practices for aligning with this shift in the form of Imaging 3.0® case studies. As part of this effort, ACR has partnered with the Association for Medical Imaging Management and RBMA to release case study-based presentations that can easily be plugged into practice, committee, and executive leadership meetings to help tell the Imaging 3.0 story. Each presentation comes with a script, notes, case study and other resource
links, and downloadable slides.
To access the presentations, visit acr.org/Imaging3Resources.

New Imaging 3.0 Case Study: Radiology in Rwanda

A new Imaging 3.0® case study explores how Sughra Raza, MD, FACR, a breast imaging radiologist at Brigham and Women’s Hospital, has been leading breast ultrasound and image-guided biopsy training as part of her volunteer work with a healthcare nonprofit in Rwanda for the past several years. Raza’s efforts have saved more than 100 women from unnecessary biopsies.
Read the case study at acr.org/Imaging3-Rwanda.

To Avoid Lawsuits, Radiologists Should Be More Clear With Referring Physicians

According to a recent JACR® article, radiologists would do well to have a conversation with referring physicians whenever possible in cases of unexpected findings in their patients. The study examines the legal outcomes in a case in which unexpected cancer findings were not verbally communicated by a radiologist to a patient’s referring physician and the patient died of cancer months later. According to study author Leonard Berlin, MD, FACR, “Failure to directly communicate a significant unexpected finding to a referring physician that results in severe harm or death to a patient may not only violate the radiologist’s legal duty but even more important his or her ethical and moral duty as well.”

To read the full study, visit bit.ly/JACR_Berlin.

ABR Launches New Online Longitudinal Assessment

This month, the ABR debuted its new Online Longitudinal Assessment (OLA) for diagnostic radiology. According to ABR President Brent J. Wagner, MD, the OLA is designed to meet the requirements
of Maintenance of Certification Part 3 — Assessment of Knowledge, Judgment, and Skills. Wagner says, “The OLA is not an examination, but a tool for both assessment and education.” The OLA is also meant to have minimal impact on a diplomate’s workday, finances, and personal life, in contrast to the previous in-person exam, which incurred expense and time away.
For more information about the OLA, visit theabr.org.

Renew Your 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. Now is the time to renew your annual pledge. Be sure to check out the latest radiation safety case for free CME.
Visit imagewisely.org today to renew.

Practice Leaders Forum Offers Practical Management Solutions

The 2019 ACR-RBMA Practice Leaders Forum, taking place Jan. 11–13 in Houston, will help radiologists and medical imaging business managers overcome professional challenges related to evolving healthcare. The sessions will focus on new practice models, leadership succession planning, employee engagement, conflict resolution, Quality Payment Program readiness, and ways to prepare for the coming integration of AI.
To register, visit acr.org/practiceleadersforum.

AI Can Triage Chest X-Rays, but Can’t Replace Radiologist Reads

According to a recent study published in PLOS One, an AI algorithm is helpful in assisting radiologists with interpreting routine chest X-rays and detecting changes on serial studies, but the technology is limited in its ability to actually read exams. Researchers found that a “DL [deep learning] algorithm can aid in interpretation of CXR (chest radiographs) findings and their stability over follow up CXR,” but that “in its present version, it is unlikely to replace radiologists due to its limited specificity for categorizing specific findings.” Study results demonstrate AI’s potential usefulness in expediting image interpretation in “emergent situations where a trained radiologist is either unavailable or overburdened in busy clinical practices” and that AI “may also serve as a second reader for radiologists to improve their accuracy.” But ultimately, because of its limited functionality, AI can’t categorize or interpret specific findings — we still need a radiologist for that.

For more information, visit bit.ly/CXR_DL.

ACR Announces New Population Health Management Committee

The ACR’s Commission on Patient- and Family-Centered Care recently announced the formation of a new committee dedicated to population health management. The Population Health Management Committee will work to ensure that high-quality patient care is an integral part of the effort to improve the overall health of populations.
“We will strive to help guide ACR members in avenues of engagement with population health management, whether it’s through adoption of low-dose chest CT, opportunities to increase screening, or following up on important findings such as abdominal aortic aneurysms and lung nodules,” notes Syed F. Zaidi, MD, chair of the new committee. “We must make sure patients don’t fall through the cracks of our fragmented health system.”

For more information, visit acr.org/PHMCommittee.

ACR: Your Career Partner

At the ACR Career Center, the premier recruitment resource for radiology employers, you can secure your next position or help top employers find you. Post your CV, sign up for job-related emails, and access
online tools and resources to boost your job-seeking success. You can also browse more than 600 new postings each month, update your CV, and sign up for customized alerts to get the positions you want delivered to your inbox.
Learn more and register at jobs.acr.org.

The QPP in Year 2

CMS has released an infographic outlining details about provider participation in year 2 of the Quality Payment Program (QPP). Within the infographic you can find a link to the CMS QPP Participation Status Tool, as well as all of the important dates and deadlines, performance categories and weights, linked overview articles, and technical assistance related to the Merit- Based Incentive Payment System and Advanced Alternative Payment Models.
For more information, visit acr.org/QPPor. To access the infographic, visit bit.ly/QPPY2_Infographic.

Power Up With RLI

The Radiology Leadership Institute® Power Hour webinar series, chaired by Geoffrey D. Rubin, MD, MBA, FACR, and Jennifer Nathan, MD, is a selection of quarterly webinars that provides radiologists at all
career stages with valuable insights on a host of leadership and healthcare topics. The next in the series, “Achieving Alignment with the Healthcare System,” will take place on Thursday, Jan. 24, 2019, at 8:00 p.m. EST, and will focus on how a radiology department can better understand its place within the larger healthcare ecosystem.
For more information and to register, visit acr.org/RLI_PowerHour.

Here's What You Missed

The Bulletin website is home to a wealth of content not featured in print. You’ll find blog posts, extra articles, and other updated multimedia content at acrbulletin.org. 
Price Transparency and Quality in Imaging
The executive director of a radiology practice discusses better ways to help healthcare consumers understand the cost and quality of their imaging services before their encounters at bit.ly/PriceTransparency_Coleman.
A Brief History of Image Wisely
Thomas A. Reher, MD, discusses the ways in which Image Wisely® promotes patient safety through reduction of radiation exposure at bit.ly/TimetoImageWisely.
When Patients Can’t Afford Cancer
Chelsea J. Miller, MD, shares her perspective on the role radiation oncologists play in striving for health equity and ensuring cancer treatment isn’t cost prohibitive for patients. Read more at bit.ly/FinancialToxicityofCancer.

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