“Over 3 full days of sessions, dozens of TED-style talks, intimate workshops, and an engaging innovation lab, I left San Diego a different person than when I arrived … that says a lot given I hang out in the future most of the time in my daily work.”
Zayna Khayat, Ph.D, Applied Health Futurist, Conference Attendee
Image Credit: NextMed Health 2023
After a three-year hiatus, the annual gathering of the future of health community resumed in San Diego with a refreshed brand, NextMed Health. This is the once-a-year space to get a ‘state of the state’ update on shifts underway in the future of health, healthcare, and medicine. This includes care models, key populations with unmet needs, and – of course – emerging technologies that are developing on an exponential curve.
Having spent over forty years attending healthcare conferences worldwide, I’m pretty jaded when assessing the quality and benefits of attending an event. But I’ve been following this conference over the years (since 2016 when it was Exponential Medicine) and have been consistently impressed by the quality of the programs and the take-home value of the information presented. If you are interested in the future of healthcare, this is a must-attend event, in my opinion. Why do I say that? There are multiple reasons.
The Organizers – NextMed Health builds on the success of the Exponential Medicine program, which Dr. Daniel Kraft has spearheaded. Daniel is a Harvard & Stanford trained physician-scientist who lives at the interface of healthcare, technology & innovation. He founded, chaired, and curated Exponential Medicine for a decade before evolving it to NextMed Health. He is an Aspen Institute Health Innovation Fellow and Kaufman fellow. Shawna Butler, RN, MBA Combining clinical acumen, health economics, and technology to catalyze cross-sector collaboration that democratizes and delivers better health, experiences, and outcomes, she brings sharp wit, (un)common sense, and empathy-driven design to projects worth doing. Her talent is scanning the horizon for game-changing patterns and identifying + connecting the clever optimists provoking them.
The Faculty – includes more than 70 leading thinkers, icons, and practitioners from around the globe. They provide examples and insight into the right-now landscape of converging technologies shaping the healthcare ecosystem and lessons on the ‘how-to’s to leverage new possibilities into meaningful scale and impact. Mainstage programming is complemented by over 20 interactive breakout sessions and a hands-on Innovation Lab featuring over 60 transformational ventures. Here’s a link to this year’s faculty.
The Content – The breadth and depth of the information presented over the three days of the conference is staggering. I’m still trying to wrap my mind around the concepts and innovations presented and imagining the opportunities they open up. Here’s a link to the program.
The Now, Near, Next framework – I loved how each faculty member incorporated what is here NOW in clinical practice, what is NEAR (in proof of concept testing), and what is NEXT into their talks.
“I left with a feeling that we are truly at an inflection point on our exponential journey.”
Zayna Khayat, Ph.D., Applied Health Futurist, Conference Attendee
The opportunity to watch via live streaming – I applaud the fact that the conference organizers decided to live stream the event this year. Since attendance is by application and invitation and is limited to 600 industry shapers making solid contributions in their fields, and since some of us old guys have limited financial resources available for registration, hotel, and travel expenses, the ability to watch in real time was greatly appreciated.
Providing a crowdsourced conference summary document – What a terrific idea! Instead of searching for summaries and conclusions, having a crowdsourced document puts relevant links and summaries at your fingertips. Here’s a link to the document. And here’s a link to a video where Dr. Kraft describes the effort and his vision for it. Bravo!
I’ve quoted Zayna Khayat, Ph.D., several times in this post. She’s done a fantastic job of summarizing her experience at the 2023 NextMed conference in a series of five LinkedIn posts. Here’s a link to the first of these five posts, and you can link to the other four at the end of each article.
Congratulations to everyone involved in the NextMed Conference. This should be the model that others follow when planning and executing successful healthcare conferences in the future. Can’t wait to see what you come up with for next year!
“The digital health summit is a very prominent part of the overall experience. We’re starting to see the lines between regulated medical devices and health, wellness, lifestyle devices converge.”
Joel Goldsmith, Director, Digital Platform, Abbott Diabetes Care
Image Credit: Consumer Technology Association
Every January, thousands of “techies” descend on Las Vegas to attend the annual Consumer Electronics Show to see what new things are on display and geek out on the futuristic technologies (some of which will probably never reach the market) that are demonstrated.
Digital health was at the forefront of this year’s Consumer Electronics Show, with notable speakers, announcements, events, exhibitors, and even a startup pitch competition. It isn’t easy to cover all of the products and features shown, but after reviewing all the reporting and checking out some of the companies websites, here are a few that I found interesting.
There was an odd obsession with smart toilets this year – At this year’s show, a quartet of companies is showing off urine analysis tools designed to be used at home by the general public. Most of them are built for your toilet, testing your urine for many easy-to-identify maladies.
The most talked-about gadget at CES was indeed Withings’ U-Scan. The company showed off a device that sits on the dry part of your toilet bowl and samples some of your trickle as you urinate. Once that fluid is captured inside the device, it runs a sample through a microfluidic cartridge (with reaction paper) and uses a reader to look at the result. Once completed, the results are sent to your phone, with suggestions on what you might do to improve your health. When it’s eventually released, U-Scan will offer a cartridge for menstrual cycle tracking, as well as one to monitor your hydration and nutrition levels.
Image Credit: Withings
Korean company Yellosis graduated from Samsung’s startup incubator some years ago and has already produced the Cym Boat personal urine testing kit. At the show, it also showed off its next-generation product, Cym Seat, which uses a metal arm to hold a paper stick under a person as they urinate. Once completed, it slides the strip in front of an optical scanner, and after a minute, the results are pushed to your phone. But this device, expected to launch by the end of 2023 and cost around $1,000, automates the existing process rather than adding anything new.
Vivoo, which also offers a reaction-paper stick that a smartphone app can analyze, is building its own toilet-mounted hardware, which pushes a urine stick into the toilet bowl and then pulls it back in once it’s collected a urine sample. An optical scanner then reads the reaction squares before depositing the stick in a collection bin for disposal later.
Finally, there’s Olive, which is taking a dramatically different tack. The device harnesses spectroscopy rather than reaction paper, with hardware that sits under your toilet seat and a bank of LEDs flashing toward rear-mounted photodiodes. The potential for such a technology is far greater than reaction paper, and some studies have pointed to being able to identify infection with it.
My take – I’m not sure how large the addressable market would be for these smart toilets. There are issues, including around data security, especially for menstrual cycle tracking in countries like the US. Companies that could expose fertility data will need to be mindful of the legal context that is presently in place post-Roe. Will these devices be accurate enough for the jobs they’ve been bought to do? And will the conclusions they provide be worthwhile? There’s a lot to work through before these products become ubiquitous in bathrooms worldwide.
Next is a medical-grade smart ring from Movano. After announcing the Movano ring at last year’s CES, healthcare solutions company Movano Ring upped the ante this year with its new smart ring, Evie. If cleared by the FDA, the ring will be the first consumer wearable that is also a medical device. Evie is designed to give women a full picture of their health, including resting heart rate, period and ovulation tracking, sleep stages, SpO2 levels, skin temperature variability, and more.
Image Credit: Movano Health
“We are bringing together medical grade biometric data and insights in a comfortable and contemporary wearable that allows women to take ownership of their unique health journey.”
Dr. John Mastrototaro, CEO of Movano Health
My take – Movano Health is going after Oura, the market leader in this wearable segment. While it is nothing revolutionary, it is a good step forward in the market of subtle wearable tech. It will be interesting to see how long the FDA process takes – especially since the company is touting Evie as a medical-grade wearable device.
Can taking a selfie potentially save your life? – NuraLogix’s Anura app demonstrates the usefulness of a selfie with its technology that can check vital signs using a cell phone camera. The app uses artificial intelligence to offer about 1,000 diagnostics with a 30-second selfie. The diagnostics include heart rate, blood pressure, stress levels, blood sugar levels, and more. The app is available on both the Apple and Google app stores.
Image Credit: NeuraLogix
My take – Despite the claims, there’s a big disclaimer on their website that reads:
For Investigational Use Only. Anura™ is not a substitute for the clinical judgment of a health care professional. Anura™ is intended to improve your awareness of general wellness. Anura™ does not diagnose, treat, mitigate or prevent any disease, symptom, disorder or abnormal physical state. Consult with a health care professional or emergency services if you believe you may have a medical issue.
Real-time wearable hydration monitor – Epicore Biosystems unveiled its new Connected Hydration sweat patch and mobile app at the 2023 CES. Connected Hydration is the first electronic wearable that continuously measures sweat fluid and electrolyte losses while monitoring skin temperature and movement. To prevent hydration, an alarm goes off on the device when wearers’ fluid loss exceeds two percent of body weight. According to Epicore, the device is intended for people who work in harsh conditions, athletes grappling with extreme heat, and people living through severe heat waves.
Image Credit: Epicore Biosystems
My take – At first glance, this device might appear to have limited market appeal. But the statistics around this problem are staggering. The harmful effects of high temperatures diminish physical and cognitive performance, leading to a staggering 170,000 work-related injuries and 2,000 fatalities annually in the United States. The increasing temperatures also reduce productivity, with total global labor productivity expected to decrease by more than 18% if temperatures rise by 1-3 degrees Celsius. Excessive environmental heat also takes a financial toll, costing employers upwards of $79,000 in worker compensation per affected worker.
Technology to help people with speech issues – Whispp demonstrated its AI-powered smart speech amplifier app and technology. The company’s mobile app converts whispered speech, vocal cord-impaired speech, and severe stutters into a person’s natural voice in real time. This allows users to make themselves heard anywhere while maintaining their freedom of movement.
YouTube Video Credit: Whispp
My take – The technology developed by this Netherlands-based company can aid the more than 500,000 people in the U.S. who have severe issues with voice disorders or stuttering or cancer patients who have difficulty speaking.
Portable virus detector – Opteev Technologies debuted its affordable and convenient breath analyzer, Virawarn. According to the company, the compact and reusable device can detect COVID-19, Influenza, and RSV in less than 60 seconds. Virawarn uses a silk-based biosensor that attracts the electrical discharge of respiratory viruses and an artificial intelligence processor that filters out any potential inaccuracies. Users turn it on, blow twice into the mouthpiece, and an LED notification light will indicate a positive or negative result in under 60 seconds. ViraWarn is reusable and comes with multiple biosensor replacement cartridges that only require being replaced after a positive result or after a period of 2 – 3 weeks of daily usage.
Image Credit: Opteev Technologies
My take – The company just submitted ViraWarn to the US Food and Drug Administration (FDA) for Pre-Emergency Use Authorization (Pre-EUA). Breath is one of the most appealing non-invasive sample types for diagnosing infectious and non-infectious diseases. Exhaled breath is very easy to provide and is less prone to user errors. Breath contains several biomarkers associated with different ailments that include volatile organic compounds (VOCs), viruses, bacteria, antigens, and nucleic acid. Results with COVID-19 detection were highly successful, with 95% Sensitivity and 90% Specificity.
Also, assistive technologies were prominently featured at CES this year. The need for assistive technologies is increasing and is likely to grow due to at least four interrelated reasons: an aging population, increases in the prevalence of disability, increases in the burden of chronic disease, and the corresponding increased load placed on caregivers.
L’Oréal announced plans to release late this year Hapta, a computerized makeup device with motion controls, to help people with limited arm mobility apply lipstick.
YouTube Video Credit: L’Oreal
The Scewo Bro is an adjustable-height wheelchair designed by roboticists and inspired by luxury vehicles. The device is about the same size as a traditional powered wheelchair, but it has two wheels and a pair of tank-like treads for rocky terrain and stair climbing. When approaching stairs, users tap a button. Laser sensors detect how steep the stairs are, and the chair automatically adjusts for the climb. The company tested it with several hundred wheelchair users and tweaked the design based on their feedback.
Image Credit: Scewo AG
Samsung Electronics is adding a mode to new TVs which can outline shapes and content for visually impaired viewers. Relumino Mode is a new picture mode from Samsung that is specially adapted for the visually impaired. When activated, this picture mode highlights contours, lines and colours, making the picture easier to interpret. For a person with normal vision, it may resemble a cartoon-like filter, but for a person with impaired vision, this may be exactly what is needed to decipher and understand the action.
Image Credit: Samsung Electronics
Toronto-based eSight showed its coming wearable for people with vision impairment caused by macular degeneration, glaucoma and other eye conditions.
Image Credit: eSight Eyewear
My take – Older Americans represent a growing audience for assistive technology and fuel a growing demand for increased accessibility in other products. The spotlight on accessible technology also comes as Americans face a financial strain, which might drive people to put “need” purchases over “want” purchases. And while the price tag for innovative assistive devices is often initially too high for many people who need them, startups are trying out subscription payment models for gadgets that insurance won’t cover.
Finally, for a terrific review of the key technologies featured in the age-tech space, I highly recommend this post from Keren Etkin, gerontologist, entrepreneur and author of The AgeTech Revolution – a book about the intersection of tech and aging. Keren’s blog is my go-to resource for all things age-tech related.
2023 looks to be a pivotal year for digital health companies as macroeconomic conditions continue to push investors’ demand for profitability over growth. At the same time, customers (in the form of patients, providers, employers, and insurers) are looking for technologies that prove their clinical worth and deliver seamless care journeys. Point solutions are out of favor as patents, providers, and employers are looking for integrated solutions that combine critical data with analysis tools into a comprehensive data set that reduces costs, improves care provider productivity, and improves clinical outcomes. Companies that cannot provide clear evidence that they can meet these requirements will struggle in this environment.
“If we expand our thinking to the patient’s perspective, we will find that imaging’s value extends beyond the tight focus of the radiologist or radiation oncologist.”
Bruce G. Haffty, MD., RSNA President
Image Credit: RSNA.org
For medical imaging professionals, Thanksgiving weekend is usually an abbreviated affair. After enjoying dinner with family and friends on Thanksgiving day, they pack their bags, brave the busy travel issues, and head to Chicago for the annual Radiological Society of North America Conference and Exhibition. For over forty-five years, that was part of my schedule every year too. Now I follow the conference virtually and thought I’d share some thoughts on what’s being featured this year.
Attendance
Based on the early figures released by the RSNA, total attendance returns to typical figures, although they are still slightly below pre-pandemic levels. Total advance registration this year was 34,385, a 61.4-percent increase over the 21,300 registered on this equivalent day in the conference in 2021. Among the 34,385, 19,485 were registered as professionals. Last year, COVID-19 was still impacting attendance, while the 2020 conference had to be made entirely virtual because of the pandemic. The attendance figure for RSNA 2019, the last year before the pandemic hit, was 47,011 (with 21,837 professional registrants); in 2018, that number was 48,615 (with 21,837 professional registrants), while in 2018, the figure was 48,615, and in 2017, total attendance had been 48,445. There is still a mix of in-person and virtual attendees, and the international attendance figures appear to be closer to normal numbers, even with outbreaks happening in China and other countries at the current time. So, RSNA still lives up to its reputation as the largest medical conference in the world.
Exhibitors
The number of vendor companies was up considerably as well. This year, 647 vendors are exhibiting at McCormick Place, a 13.3-percent increase over the 571 vendors that exhibited last year. Back in 2019, the last pre-pandemic year, 789 vendors had exhibited, while in 2018, 693 had exhibited.
The virtual vendor experience
I spent some time exploring the various vendors’ online virtual booths to try and understand what was new and how they were positioning their products this year. Virtual RSNA evolved from the years when COVID prevented onsite meetings. The first year left a lot to be desired, but it has evolved and become much better since then. But the user experience is decidedly mixed. Some of the interfaces are unintuitive, and the loading times are really slow – surprising in this day and age. Several websites give you information that is untainted by fluff, but so many are poor at best and abysmal at worst. I wish I had a nickel for every vendor who “developed the DICOM standard” or “is leading the charge in AI in medical imaging.” I could fund a vacation with the money.
What was being featured this year
A.I. Again – Once again, this year, there’s a big focus on A.I. applications in medical imaging. AI has applications across the radiology spectrum, including using natural language processing algorithms to help collect and process data for clinical research. Using the Gartner Hype Cycle framework, I think we’ve reached the point where AI is exiting the “peak of inflated expectations” phase and heading down to the “trough of disillusionment.” Practical experience in everyday practice has exposed the challenges of implementing AI. The biggest challenge is integration – at every step in the imaging value chain.
Which algorithms should be used and for which applications? How does the AI fit into the radiologist’s workflow? How does AI complement the radiologist’s diagnosis? And how does it impact the care pathway? These essential questions must be answered to allow for the widespread adoption of the technology.
Cloud, Cloud, and more Cloud – The benefits of Cloud solutions, such as their cost-effectiveness and predictability, unlimited scalability, and deployment flexibility, have started to outweigh the perceived risks. This is especially true in medical imaging, where the unending growth in image data volumes, coupled with long-term data retention policies in place, makes traditional storage upgrades and scale-up mechanisms unsustainable over the long run. This is why, since the early 2000s, Cloud-based solutions have provided a viable alternative to tape- and truck-based solutions for the long-term archival of medical image studies.
Two simultaneous and complementary market trends are advancing Cloud-based imaging informatics into new use cases: the continuous expansion of medical imaging applications into niche subspecialty clinical areas and the ongoing diversification in the points of care where medical multimedia content is produced and consumed by various enterprise imaging stakeholders.
Every major vendor of cloud solutions exhibited at RSNA this year: Microsoft. Google, Nuance, and NVIDIA all had major exhibits.
Photon counting CT – Photon-counting detector (PCD) CT is a new CT technology utilizing a direct conversion X-ray detector, where incident X-ray photon energies are directly recorded as electronic signals. The design of the photon-counting detector itself facilitates improvements in spatial resolution (via smaller detector pixel design) and iodine signal (via count weighting) while still permitting multi-energy imaging. PCD-CT can eliminate electronic noise and reduce artifacts due to the use of energy thresholds. Improved dose efficiency is vital for low-dose CT and pediatric imaging. The ultra-high spatial resolution of PCD-CT design permits lower dose scanning for all body regions. It is particularly helpful in identifying important imaging findings in thoracic and musculoskeletal CT. Improved iodine signal may be helpful for low-contrast tasks in abdominal imaging. Virtual monoenergetic images and material classification will assist with numerous diagnostic studies in abdominal, musculoskeletal, and cardiovascular imaging. Dual-source PCD-CT permits multi-energy CT images of the heart and coronary arteries at high temporal resolution.
Multiple presentations at RSNA this year highlighted the benefits of photon-counting CT in medical imaging. For example, PCCT is feasible for the imaging of heart defects in neonates and infants, offering a superior signal-to-noise ratio and image quality than conventional CT.
Empowering Patients – I was pleased to see this topic as a focus this year. To the patient, imaging can remove uncertainty, decrease anxiety and give hope. A significant challenge is objectively quantifying the patient’s perception of value to demonstrate its importance to the greater medical community. From the time a patient schedules an appointment through every follow-up, effort should be made to ensure they feel comfortable, informed, supported, seen, and heard. Image results are the tip of the iceberg. Imaging’s actual value through the lens of the patient—quality of life, comfort, peace of mind, certainty, hope, and trust— all lies below the surface for us to explore together.
What we didn’t see – There were no significant new product introductions at the meeting this year. Vendors essentially rounded out their product portfolios with missing elements at lower price points. I think that reflects the current market conditions where health systems are under intense margin pressure, meaning less capital is available for purchasing big-ticket items like MRI scanners. The case vendors need to make is all around efficiency, throughput, clinical benefit, and cost reduction.
Final thoughts – RSNA is still my favorite conference to follow during the year. It’s the one place where medical imaging professionals gather to review the state of the industry, explore new products and technologies that are entering the market, share clinical applications that broaden the use of medical imaging throughout the care continuum, and celebrate the contribution that imaging makes for improving the lives of the patients we serve.
“It is important that we understand the importance of our role in a value-based system and leverage the tools that enhance our ability to provide subspecialized expertise to patients, the medical community and the public at large.”
Mary C. Mahoney, M.D., President, RSNA
Image credit: Shutterstock.com
Last week the annual Radiological Society of North America conference and exhibition was held in Chicago. As I highlighted in my previous post, this is the largest medical imaging conference in the world. And although the pandemic has forced some tough decisions to be made by the conference organizers, this year marked a return to in-person attendance – albeit with some significant modifications to the rules.
I decided to follow the conference remotely again this year. And, I must admit that I didn’t miss the trip to Chicago and the endless walking through the exhibit halls of McCormick Place to check out all the vendor offerings. But, since I’ve spent the bulk of my professional career in medical imaging, I’m still interested in the technology, the profession, and the clinical developments in the industry. So, after spending the past week reading all of the press releases, watching the virtual vendor presentations online, and talking with some of my former industry colleagues, I thought I would share some observations on both the educational and technical exhibitions.
General Observations
RSNA 2021 Attendance Sees 55% Drop from 2019 Level – The total in-person registration as of November 29th was 21,300, including 11,173 professionals registered. Final registration totals will be available in early January. That 21,300 figure is down 55% from the overall attendance figure for RSNA 2019, which was 47,011 (with 21,837 professional registrants). That figure had, in turn, represented a 3.3-percent drop from the 48,615 statistics from RSNA 2018, while in 2017, the total attendance had been 48,445. The advance registration for this conference was 26,348 (with professional advance registration at 16,028). The number of vendor companies of all types exhibiting this year has also declined significantly from two years ago. This year, 571 companies exhibited, down 27.63% from the 789 exhibited in 2019. That 789 figure at RSNA 2019 had represented a 13.8-percent jump over the 693 shown in 2018. As reported by on-site attendees, there were between 40 and 50 vendor no-shows where booths sat empty.
The RSNA did an admirable job creating a safe environment for attendees throughout the conference and exhibition. Registrants were required to show proof of vaccination before receiving their conference credentials. On-site registration was said to be very easy, taking only about five minutes, according to some reports. Masks were required at all times – a City of Chicago requirement. RSNA also offered two onsite COVID-19 testing options during RSNA 2021, with results available 60 minutes after testing.
Several colleagues I spoke to who attended in-person said this was the best RSNA they’ve attended. The lower attendance allowed for companies to present to those who were serious about implementing technology sooner than later. You could have a substantive conversation without having someone else crash your demonstration.
Educational Sessions
Addressing inequities in access to medical imaging – Radiologists are well-positioned to develop strategies for mitigating health disparities through the thoughtful application of radiologic technology. This includes utilizing electronic medical records and demographic data to identify individuals at an increased risk of missing screenings or missed follow-up imaging. Targeted outreach can then be offered to avoid these missed opportunities for care. The hope is that the coalition of patient-focused radiologists will collect and disseminate resources and best practices, advocate for and connect with patients and community members, and collaborate on programs and services that empower others to act.
AI in medical imaging – Applications that improve radiologist efficiency was not nearly as likely to attract investment as those that help organizations capture more patients. An AI application that helps bring more patients back for follow-up imaging, for instance, has the potential to add tens of thousands of dollars to an organization’s bottom line. Adoption remains low, however, with only one-third of organizations currently using AI in their practices. AI continues to demonstrate promise as a tool to speed up imaging exam times — up to 70% faster for spine MRI studies — and reduce dose, including 90% less dose needed for gadolinium-based contrast agents. More on AI in the technical exhibits section in a bit. Here’s a great graphic from Dr. Bertalan Mesko and his team at The Medical Futurist Institute showing the major milestones in AI development in healthcare:
Image Credit: Bertalan Mesko, M.D.
Radiomics role in medical imaging – Several sessions discussed the increasing use of radiomics in clinical practice. One session reviewed applying radiomics, and machine learning to FDG-PET/MRI can noninvasively assess nodal status and treatment planning for breast cancer patients. Out of the eight radiomics models the team developed, the one that had radiomics features extracted from dynamic contrast-enhanced images, antibody-drug conjugates, and PET images showed the highest accuracy for predicting lymph node status. Another presentation reviewed a combination of radiologist assessment and a radiomics classifier to significantly improve the accuracy of MRI for predicting treatment response in cases of rectal cancer. Presenter Mitchell Chen, Ph.D., of Imperial College London in the U.K., and colleagues assessed the utility of CT radiomics in a retrospective study involving 292 NSCLC patients diagnosed at their institution over four years. They presented clear evidence supporting the clinical utility of CT-based radiomic analysis in NSCLC.
Technical Exhibition
AI promoted heavily, but buyer beware – Over half of the vendors claimed to have some form of artificial intelligence (AI), including nearly all the major companies. That said, you needed to dig deeper to understand what they meant by AI versus the industry’s shared understanding of AI. While there are standards for AI, there still isn’t a uniform descriptor of what medical imaging AI is other than what is in the mind of some company’s marketing department. Yes, AI can help with improving signal-to-noise ratios and even with adapting hanging protocols, but that is not what most people are looking for when they look at AI. As reported by Michael Cannavo:
“Real AI” was out there, although anyone who says it is a developed marketplace is sadly mistaken. Fewer than a dozen vendors have more than 20 paying customers using their algorithms, even though they might claim to have 200. Alliances are being formed between several AI vendors who have decided to partner up after realizing the movie dialogue cliché, “this town ain’t big enough for two of us,” or in the case of radiology AI, the 200+ of them.
Michael J. Cannavo, Aunt Minnie.com article
Reimbursement is still an issue. New Technology Add-On Payments (NTAP) are a class of reimbursement meant to help pay for new technology that is not included in the diagnosis-related group (DRG) bundled payment. Unless something changes, NTAP payments for AI applications will expire next year. And, radiologists have finally realized that platforms are more important than point solutions for AI. As Mike points out in the quote above, there’s significant consolidation in the industry, and partnerships to create total AI platform solutions will become dominant in the next several years. Here’s a link to a video interview Brian Casey, Editor in Chief of Aunt Minnie, did with Dr. Paul Chang of the University of Chicago on AI in imaging at RSNA 2021.
Informatics – PACS, vendor-neutral archives (VNA), and enterprise imaging systems (EIS) were all displayed on the exhibit floor, with VNAs making a resurgence of sorts. But with a few exceptions, most of the excitement around PACS/EIS primarily involved upgrades for those using their existing products. PACS vendors continued to place a major emphasis on their respective cloud advantages, and there was a widespread consensus that cloud is on every imaging IT roadmap.
Photon-Counting CT is the talk of the exhibition – Siemens Healthineers executives touted the benefits of its photon-counting CT technology, which is finally reaching the market after 15 years of development work. There are currently over 20 scanners in operation in the U.S. and Europe, most at university hospitals, according to company executives. The fact that they were able to keep this under wraps until the RSNA had competitors scrambling to counter the announcement. In a press release, GE reported that researchers at Karolinska Institute in Sweden had begun clinical evaluations of a photon-counting CT scanner based on technology from GE Healthcare. And Canon Medical announced that they launched a project with the National Cancer Center Japan to evaluate a new photon-counting CT scanner. Both press releases were pretty much drowned out by the hoopla surrounding the Siemens product launch. Philips promoted their spectral CT scanner and had no mention of photon-counting.
Here’s a link to a video interview that Brian Casey, Editor in Chief of Aunt Minnie, did with Cynthia McCollough, Ph.D., of the Mayo Clinic about photon-counting CT.
Mobile imaging systems take center stage – I’ve discussed the topic of bringing medical imaging to the patient in a previous post. This year’s technical exhibition reinforced that message with several new product introductions and first-time exhibitors. Hyperfine had a booth at the conference to demonstrate their Swoop portable MRI system. Fifty organizations are currently using Swoop. A partial list of these organizations includes Yale-New Haven Hospital; North Shore University Hospital (part of New Hyde Park, New York-based Northwell Health); University of California Irvine; Massachusetts General Hospital; Danbury, Connecticut–based Nuvance Health; and Ohio State University. Samsung Neurologica introduced updated versions of their portable CT systems: OmniTom Elite and BodyTom 64 (FDA 510k pending). New versions of handheld ultrasound systems were on display at several vendors booths. Redesigned mobile digital x-ray systems with smaller profiles, lighter weight, and longer battery life were also shown. This trend will grow in importance as more patient care is delivered in the home, in retail settings, and other points of care outside of the hospital.
MRI: Hold the cryogens, please – While there were many updated products announced at this year’s RSNA, the big trend is toward reducing the need for cryogen refills on systems. The technology seals helium directly into the magnet, such that scanners do not require helium refills or quench pipes. Philips, GE, and Siemens promoted their versions as part of their press releases. Vendor portfolios continue to expand with configurations at 1.5, 3.0, and 7.0 Tesla field strengths. New introductions of permanent magnet open systems like the Velocity MRI from Fujifilm Healthcare were also demonstrated.
Some concluding thoughts:
The imaging industry made the most of RSNA 2021, and everyone seemed happy to be together again after two long years of working from home. As reported by Jake Fishman in The Imaging Wire, “almost every product message at RSNA focused on productivity and efficiency, often with greater emphasis than clinical effectiveness. The AI Showcase highlighted many trends we’ve been seeing all year, including larger vendors transitioning to AI platform strategies, an increased focus on workflow integration and care coordination, and a greater emphasis on radiologist efficiency.”
My one beef is with the marketing messages from some of the vendors. I know it’s tough to differentiate yourself in a mature market, but some of the messaging left me scratching my head. Some examples:
We’re going to “democratize data-driven medicine, together.” What does that mean exactly?
Our product is FDA approved. No. The FDA doesn’t approve products; they clear them to be marketed, but that’s it.
Companies that use numbering designations for their product portfolio. Really? Is 5500 better than 7500? Is the price different for a 3100 than an 8800? My head hurts….
Disney-esque knockoffs especially drive me crazy. You folks know who you are. “People Can Tell When You Imagine.” I’d rather not imagine it but actually do something.
I’d worry about a company that touts that their product addresses “clinically significant cancer.” Most patients who receive a cancer diagnosis think their condition is “clinically significant.”
The same goes for companies who use the “Patients are at the center of all we do” tagline. Maybe if we really were at the center of all you do you’d give us access to our medical data without requiring us to sign away our first-born child or re-mortgage our homes to get a digital copy. And don’t get me started about fax machines….
I can’t even count the number of press releases or online virtual exhibits that used the words paradigms, proliferation, future-proof, future-powered, pressing trends, and my personal favorite, ubiquitous. Perhaps spending $32.99 on the latest edition of Roget’s Thesaurus would be in order here?
And finally, companies who still insist on using stock photography showing a physician holding up a film of a CT or MRI scan in their promotional materials. News flash – it’s almost 2022, folks. A Shutterstock subscription doesn’t cost that much. But, if you’re serious, I think I still have a lightbox in my basement that I used to do slide editing. Yours free for the asking.
A couple of weeks ago, I wrote a post on what to expect from the conference. So, how did I do with my prognostications? Most were pretty obvious based on the information available at the time. My wild card guess didn’t get as much notice as I thought. And I was delighted to see that the PACSman Awards were featured again this year on Aunt Minnie.com. Looking forward to seeing what happens in 2022.
