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Reshaping the Role of Radiology    



As the 100th (!) RSNA Annual Meeting is underway, my thoughts turned to how radiology has changed and to where it’s headed. As chronic diseases take on a larger share of overall healthcare cost (86% in the US right now) and we transition from fee-for-service to accountable care models, how will this impact radiology?


How will radiology become more connected across the health continuum, like all other facets of health care? And what role can radiologists play, from prevention to definitive diagnosis, personalized treatment, recovery and wellness?


To me, the biggest change in radiology is that it is no longer just about capturing and interpreting an image. Radiologists are expanding their perspective. They analyze data from an increasing number of multiple, disparate sources. But what does that mean exactly? How will the new generation of clinical informatics impact radiology?

Let me walk you through an example.


John is identified as ‘at risk' for prostate cancer and has requested to have his PSA value measured. His primary care physician spots early indicators of prostate cancer. He is directed to the urologist who requests an MRI exam, performed by the radiologist. The radiologist identifies potentially cancerous regions, and uses software to quantify the lesion.


Shortly after, the urologist performs a biopsy, which is a complex procedure that requires fusion of images (MRI and live ultrasound) to find the right locations to take tissue samples. The pathologist then uses digital pathology to scan and analyze the tissue. The biopsy specimens are subjected to genome sequencing to further analyze the cancer.


Based on John’s profile (lifestyle, demographics, socio-economic, behavioral factors), his medical history, as captured in the longitudinal patient record, and current clinical findings, the oncologist now has a full picture to discuss a treatment plan that fits best with John’s context and risk appetite.


John chooses not to be operated on yet, but to apply for active surveillance and is now monitored by his GP while remaining in his home environment. General physical parameters are being checked remotely to support his disease management.


To support this, John has access to his data provided by his personalized app linked to the Healthsuite Digital Platform of the hospital. This helps the care team to look out for deterioration and ensure compliance with the treatment plan.

John’s example underscores the need for collaboration among several care providers, especially in complex cases. A radiologist in San Francisco can work in real time with a colleague in London, or a specialized oncology center in Singapore for a second opinion, requiring the ability to easily and seamlessly share images and contextual data, all for the benefit of the patient.


Using Cloud technology, data from cases like John’s can be aggregated and analyzed across multiple hospitals in different parts of the world to identify factors that impact diagnosis and treatment efficacy. Major leaps in machine learning allow clinicians to analyze very large data sets and derive algorithms for clinical decision support. The field of deep learning has progressed to a point where software can find patterns in highly complex images, going beyond what the human eye can see. We are witnessing an exponential increase in processing and storage capabilities. Genome sequencing technology has developed in the last years at twice the speed of Moore’s law!


Radiology will evolve with the progress of clinical technology, which is increasingly determined by the fast changes in information technology. We see the impact around us every day. It is not even five years ago that the iPad was launched and the device today is already 40 times more powerful than the 2009 version. Every day, Amazon adds in storage and computing capacity equivalent to their total capacity from five years ago.


Shortly, we will get actionable insights derived from all relevant diagnostic and patient data. Data collected from different scans, studies, electronic medical record (EMR) information, genomic data and personal patient history. The data is coming from different sources, including hospitals, physician practices, insurance companies, consumer apps and connected devices.


The radiologist will get a dramatically expanded view of the patient, reach a definitive diagnosis through actionable analytics, by tracking longitudinal data, and, by collaborating more effectively with oncologists, neurologists, cardiologists, care team members… and, yes, the patient. Clinicians can also compare each patient’s case to the data and experiences of other patients that have experienced similar journeys across the health continuum.


Radiology plays such a critical role in the health system. When we look at where health technology is headed, radiology is way beyond scans and images. It is often the launching point for a patient’s journey, where an ever-expanding array of new information will factor into how that patient ultimately moves across the health continuum.


As health care data becomes accessible, radiology will continue to increase and extend its impact in patient care – from prevention and diagnosis to treatment and recovery. The radiologist might well become the integrator and analyst of all critical clinical data.

Jeroen Tas

CEO, Healthcare Informatics Solutions and Services Philips

Jeroen Tas has over 30 years of global experience as an entrepreneur and senior executive in the financial services, healthcare and information technology industries. Currently he is the CEO of the Philips Healthcare Informatics Solutions and Services Business Group.


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