Partnership Opportunities Abound at RSNA 2013
As she began contemplating the theme of the annual meeting over which she would preside, 2013 RSNA President Sarah S. Donaldson, M.D., said the idea of highlighting partnership came naturally to her. "I always have been very focused on collaboration and what we can achieve through group efforts," she said. The RSNA 2013 Meeting Program offers numerous sessions that demonstrate precisely the kind of results that Dr. Donaldson stressed are possible when partnerships are forged and strengthened within the radiology specialty, with other specialties and with patients.
Clinical Trials Collaboration Raises Radiology's Profile
The nearly 2,800 scientific papers and posters being presented at RSNA 2013 represent significant collaboration among radiologists. Among the results being reported are those from trials conducted within the American College of Radiology Imaging Network (ACRIN), which brings together medical imaging investigators from more than 100 academic and community-based medical facilities in the U.S. and several international institutions.
"ACRIN investigators are instrumental in clinical research that is making a difference in the lives of cancer patients," said ACRIN chair Mitchell D. Schnall, M.D., Ph.D., who will become chair of RSNA's Research Development Committee at the conclusion of RSNA 2013. "Several ACRIN trials are now among the highest profile clinical trials in the National Cancer Institute's portfolio and now, as part of the ECOG-ACRIN Cancer Research Group, the opportunity for ACRIN investigators to work collaboratively across clinical disciplines is better than ever before." The ECOG-ACRIN Cancer Research Group was formed by the merger of the Eastern Cooperative Oncology Group (ECOG) and ACRIN.
Results from ACRIN 4006, which compares full-field digital mammography with digital breast tomosynthesis, will be reported at RSNA 2013. A scientific poster, "Effect of Reduced Radiation Dose on Breast Density Estimation in Digital Mammography" (LL-BRS-TU6B) and three scientific papers, "Characterization of Mean Glandular Dose Adjusted to Volumetric Breast Density in a Prospective Digital Breast Tomosynthesis Screening Trial" (SSJ22-01), "Comparison of Dose in Digital Breast Tomosynthesis and Standard Two-View Mammography for Prospective Breast Cancer Screening" (SSK01-05), and "Effect of Device Technical Factors on Patient Dose in a Prospective Digital Breast Tomosynthesis Screening Trial" (SST14-01) all detail ACRIN 4006 outcomes.
Numerous other RSNA 2013 sessions also represent the collaboration of radiologists belonging to RSNA and other radiologic societies. The ACR, American Institute for Radiologic Pathology, North American Society for Cardiac Imaging, Society for Imaging Informatics in Medicine, SNMMI, American Association for Women Radiologists, Interamerican College of Radiology and European Society of Radiology have partnered with RSNA to offer annual meeting sessions and courses this year.
Physicians From Across Globe Tackle Shared Concerns
From "France Presents" to the country pavilions in the Technical Exhibition that house companies from Germany, Korea, China, Japan, France and Canada (Ontario Province), international partnerships are an important part of RSNA 2013.
"With so many of the world's leaders in radiology present, the annual meeting provides a forum for many organizations to have international communications and involvement that otherwise could not exist," said Richard L. Baron, M.D., RSNA Board Liaison for International Affairs. "These range from industry partners seeking input from worldwide experiences to improve their products and subspecialty radiology groups sharing clinical advances, to international leadership taking advantage of this limited opportunity to tackle worldwide issues together."
Dr. Baron notes that almost 40 percent of RSNA 2012 attendance was from outside North America. The first meetings of the Regional Committee for Asia/Oceania and Regional Committee for Latin American are being held at RSNA 2013, with two additional regional committees for Europe and Middle East/Africa to be rolled out in 2014.
A session on Friday, "Radiology in the Developing World: Mistakes Made, Lessons Learned, What's Next?" (RC816) will help attendees understand how they can participate in or develop global radiology projects. The session will be held from 8:30 to 10:00 a.m. in Room S404AB.
Another case study in international partnership is a quality storyboard available for viewing throughout the week: "Establishing First-ever Radiology Services and Interpretation at Isolated Island Hospital Talaud, Indonesia—Multinational Humanitarian Radiology Cooperation" (LL-QSE-SU2B). In just two weeks in summer 2012, the radiology department aboard the United States Naval Ship Mercy Hospital coordinated an effort involving many of the ship's departments, Indonesian civilians and virtual support from mainland U.S. to repair two portable radiograph units, teach Indonesian physicians how to shoot, develop and interpret plain radiography at a small hospital that provides care to people who have to travel 10-12 hours by boat to the next level of care.
Image Sharing Benefits Patients and Providers
As Dr. Donaldson noted in her president's address, radiologists have learned that "patients want to partner with us. And we need to partner with them. It's just that simple." Some of the latest partnerships involve communicating radiology results directly to patients. A scientific poster, "Communicating Radiology Results to Patients: Results from Universal Online Release by an Academic Radiology Department" (LL-INS-SU2B), details the results of a retrospective review of utilization of the patient portal at one institution between May 2012 and March 2013—about half of the nearly 119,000 test results released via the portal were viewed by patients. Investigators concluded that many patients seek access to their imaging results, making them a partner in their care. Investigators identified potential financial benefits to the electronic sharing as well—printing and mailing costs are reduced, as is staff time devoted to fielding calls from patients looking for their test results.
A refresher course, "Vignette-based 'Disclosure of Medical Error in Radiology" (RC216) combines lectures on the risks, benefits and barriers to disclosing medical errors with live enactments between course participants and trained personnel who will portray the physicians and patients to whom errors must be disclosed. The enactments will be followed by debriefings and group discussions.
"If done properly, a well-constructed disclosure process can potentially enhance the bond between a patient and healthcare provider," said Stephen D. Brown, M.D., chair of the RSNA Professionalism Committee, which sponsors the vignette-based course.
An education exhibit, "Re-thinking the Role of the Radiologist: Enhancing Visibility through Both Traditional and Non-traditional Reporting Practices" (LL-INE3192), notes that traditional reporting practices do not give radiologists sufficient opportunities to interact with patients or referring physicians, limiting their ability to practice "patient-centered" radiology or form effective partnerships with referring physicians and recommends non-traditional reporting practices radiologists can add to their repertoire.
Healthcare Reform Drives Better Relationships
"In an era of patient safety initiatives, healthcare reform and new patient care models, it is critical that radiologists and referring physicians can work in tandem to improve their patients' care," said Judy Yee, M.D., chair of the RSNA Public Information Committee.
"What the Referring Physician Needs to Know" (RC716) will help attendees understand what referring physicians need from radiologists at various stages of patient care, as well their preferences in communication methods. Course attendees will also learn about the needs of referring physicians when it comes to structured reporting and appropriateness criteria.
For an example of how the relationship between radiologists and referring physicians can sour, there is a scientific paper, "Crying 'Wolf' about Unsatisfactory Study Quality: A Potential Rift in Communication between Radiologists and Referring Clinicians" (SSK11-02). Researchers looked at how often radiologists identify technically unsatisfactory imaging quality (TUIQ) reports from various modalities, how often recommendations for follow up are made and whether these recommendations are heeded by clinicians. Researchers found that 1 in 14 radiology reports contain comments or disclaimers related to TUIQ, with ultrasound and CT having relatively higher rates than CR. Radiologists must seek to improve communication with referring clinicians regarding the diagnostic quality of imaging studies and need for repeat imaging, the researchers concluded.
Collaborations Yield New Hardware, Software, Standards
Radiology's partnerships with industry are also moving the specialty forward, as evidenced by initiatives such as the Quantitative Imaging Biomarkers Alliance (QIBA). Organized by RSNA in 2007, QIBA brings together researchers, healthcare professionals and industry stakeholders to identify needs, barriers, and solutions to develop and test consistent, reliable, valid and achievable quantitative imaging results across imaging platforms, clinical sites and time. QIBA representatives also work to accelerate the development and adoption of hardware and software standards needed to achieve accurate and reproducible quantitative results from imaging methods. Learn more about QIBA at a kiosk in the Lakeside Learning Center.
Industry representatives also collaborate with medical imaging professionals via the Integrating the Healthcare Enterprise (IHE) initiative, which brings together users and developers of healthcare information technology to improve the way systems communicate with one another and accelerates the adoption of electronic health records. An education exhibit, "RSNA/IHE Image Sharing Demonstration" (LL-INE3252), details the latest developments in the IHE initiative and the RSNA Image Share project. There is also an RSNA/IHE Image Sharing Demonstration in the North Building, Hall B, Booth 8140.