Transcript Technology Trends and Their Impact on 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)
• Hospitals (both for and not for profit)
• Rural hospitals (both for and not for profit)
• Imaging Centers (for profit)
• Private office (for profit)
Radiology
Trends and Opportunities
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Routine Radiography
Mammography
Ultrasound
Magnetic Resonance Imaging
Computed Tomography
Vascular Interventional
Nuclear Medicine
PACS and IT
What is Needed Now
The Future
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
Technologist Work Components
Patient
Positioning
13%
Tube Position
5%
Film Handling
43%
Patient Transport
11%
Exposure
4%
Other
16%
Cassette
Handling
8%
Upright DR
Eastman Kodak Company
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
Tomosythesis
Hologic Corporation
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
3D Ultrasound
Philips Medical Systems
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
3T MRI
General Electric Company
CAD Breast MR – Volume Summary
Seattle Cancer Care Alliance – CADstream Confirma
CAD Breast MR – Angiomap
Seattle Cancer Care Alliance – CADstream - Confirma
Cardiac MR – Scar Mapping
Justin Pearlman, MD, PhD
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
Volume CT (64 Slice)
General Electric Company
Volume CT Heart
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
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
3D PET/CT
University of Texas, MD Anderson Cancer Center, PET Center
General Electric PET/CT
PACS
Picture 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
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
Patient Summary Access
Radiology Reports
Viewing Images via CIS
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
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
Questions?
Monte Clinton, CRA
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire USA
[email protected]
www.dhmc.org