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RADIOLOGY Technology Trends and Their Impact on American Healthcare

RADIOLOGY Technology Trends and Their Impact on American Healthcare. Monte Clinton, CRA Director of Radiology Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire USA Kodak Healthcare Advisory Board Shanghai. American Healthcare. Academic Medical Centers (not for profit)

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RADIOLOGY Technology Trends and Their Impact on American Healthcare

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  1. RADIOLOGYTechnology Trends and Their Impact on American Healthcare Monte Clinton, CRA Director of Radiology Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire USA Kodak Healthcare Advisory Board Shanghai

  2. American Healthcare • Academic Medical Centers (not for profit) • Hospitals (both for and not for profit) • Rural hospitals (both for and not for profit) • Imaging Centers (for profit) • Private office (for profit)

  3. Radiology Trends and Opportunities • Routine Radiography • Mammography • Ultrasound • Magnetic Resonance Imaging • Computed Tomography • Vascular Interventional • Nuclear Medicine • PACS and IT • What is Needed Now • The Future

  4. Routine Radiography • The Trends • Volume will continue to fall • Film-based imaging will remain in small facilities • The Opportunities • Digital radiography (DR) increasing • DR required for PACS and increased productivity • Chest radiography with CAD • Dedicated trauma and pediatric DR equipment

  5. Technologist Work Components

  6. Upright DREastman Kodak Company

  7. Mammography • The Trends: • Digital becoming standard in large centers • Film will continue to be used in small centers • The Opportunities: • Digital equipment with CAD • Breast MR for dense and high risk patients • Tomosythesis shows great promise • Breast biopsy in Radiology will be standard

  8. TomosythesisHologic Corporation

  9. Ultrasound • The Trend: • Volume of referrals will continue to increase • The Opportunities: • 4D in OB ultrasound • Ultrasound guided biopsy • Molecular imaging and therapy coming • New contrast agents for characterizing lesions • Gene therapy delivery • Musculoskeletal imaging – sports medicine

  10. 3D UltrasoundPhilips Medical Systems

  11. Magnetic Resonance Imaging • The Trend: • Volume will increase with new developments • The Opportunities: • Huge potential in cardiac imaging • 1.5T – 3T – 7T migration • Molecular imaging will develop quickly • New applications: Perfusion Imaging, Functional Imaging, Diffusion Tensor Imaging, Peripheral Angiography, MR Spectroscopy • Site specific contrast agents

  12. 3T MRI General Electric Company

  13. CAD Breast MR – Volume SummarySeattle Cancer Care Alliance – CADstream Confirma

  14. CAD Breast MR – AngiomapSeattle Cancer Care Alliance – CADstream - Confirma

  15. Cardiac MR – Scar MappingJustin Pearlman, MD, PhD

  16. Computed Tomography • The Trends: • The volume will increase with new techniques • Huge number of images requires PACS • Multi detector migration – 32, 64 and beyond • The Opportunities: • Cardiac CT Angiography • Coronary calcification scoring • Virtual Colonoscopy • Lung screening

  17. Volume CT (64 Slice)General Electric Company

  18. Volume CT Heart

  19. Vascular Interventional • The Trend: • Steady volume increase as more procedures are developed with Cardiology, Oncology and Vascular Surgery • The Opportunities: • CT/Interventional equipment will be standard • Cancer therapy collaboration with Oncology • Gene therapy delivery – pancreas and liver • Chemoembolization • Radio frequency ablation

  20. Nuclear Medicine • The Trend: • Volume will continue to increase - 35% Cardiac • New PET techniques • The Opportunities: • PET cardiac and Alzheimer’s screening shows great potential • PET/CT becoming the standard equipment • Functional imaging

  21. 3D PET/CTUniversity of Texas, MD Anderson Cancer Center, PET Center General Electric PET/CT

  22. PACSPicture Archive and Communication Systems • The Trends: • Major hospitals are adopting PACS • Small hospitals are hampered by high cost • The Opportunities: • Low cost (turn key) PACS for small facilities • Integration within the hospital’s electronic record • Wireless transmission of images directly to the referring clinician

  23. Radiology’s PACS and IT • The Trends: • All American hospitals to have EMR in 10 years • Billing standardization required • Portability of medical record is essential • Radiology PACS images imbedded in EMR • Radiology – IT collaboration required • The Opportunities: • Single RIS-PACS source solutions • DR/CR – RIS – PACS – HIS • Other clinical areas - Vascular - Cardiology

  24. Patient Summary Access

  25. Radiology Reports

  26. Viewing Images via CIS

  27. What is Needed Now? • Lower cost DR and PACS equipment • Integrated DR and PACS equipment • Image transmission to central interpretation hub • Equipment that enhances productivity • Well built equipment that is easy to use and maintain • Better use of mobile imaging equipment – CT, MR, PET/CT, VIR, Cardiac Catherization, Mammography, Radiography and Ultrasound

  28. The Future • Robotic imaging • Automated CAD with interpretation and reporting • Integrated RIS-PACS-HIS through I.T. • Portable medical records – perhaps imbedded in patient • Molecular Imaging • Image guided chemotherapy and gene therapy

  29. Questions? • Monte Clinton, CRA • Dartmouth-Hitchcock Medical Center • Lebanon, New Hampshire USA • Monte.Clinton@Hitchcock.org • www.dhmc.org

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