Technology Trends and Their Impact on Healthcare

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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

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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)

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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

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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

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Technologist Work Components
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Upright DREastman Kodak Company
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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

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TomosythesisHologic Corporation
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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

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3D UltrasoundPhilips Medical Systems
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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

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3T MRI General Electric Company
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CAD Breast MR Volume SummarySeattle Cancer
Care Alliance CADstream Confirma
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CAD Breast MR AngiomapSeattle Cancer Care
Alliance CADstream - Confirma
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Cardiac MR Scar MappingJustin Pearlman, MD, PhD
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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

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Volume CT (64 Slice)General Electric Company
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Volume CT Heart
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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

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Nuclear Medicine

• The Trend
• Volume will continue to increase - 35 Cardiac
• New PET techniques
• The Opportunities
• PET cardiac and Alzheimers screening shows great
  potential
• PET/CT becoming the standard equipment
• Functional imaging

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3D PET/CTUniversity of Texas, MD Anderson Cancer
Center, PET Center General Electric PET/CT
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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 hospitals electronic
  record
• Wireless transmission of images directly to the
  referring clinician

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Radiologys 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

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Patient Summary Access
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Radiology Reports
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Viewing Images via CIS
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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

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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

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Questions?

• Monte Clinton, CRA
• Dartmouth-Hitchcock Medical Center
• Lebanon, New Hampshire USA
• Monte.Clinton_at_Hitchcock.org
• www.dhmc.org