In an increasingly complex and demanding world for radiologists—one in which the word “burnout” is so common that it’s almost become cliché—healthcare IT companies have the unique responsibility and opportunity to ease radiologists’ burdens by rising to address these momentous challenges. How can technology help to increase physician satisfaction and decrease the emotional burden of meeting high-quality standards? One important contribution would be to reduce clinicians’ frustrations by increasing the flow of information with easy access to diagnostic tools and contextual patient records.
That’s AGFA HealthCare’s approach to innovating its Enterprise Imaging Platform (AGFA EI). Behind every new feature the company introduces is a common question: How can the company’s platform technology play a role in making the reading process more accurate and efficient? How can platform technology simplify radiologists’ lives by helping them address specific challenges in the contemporary, busy, image-overloaded, siloed data world?
Dan Brown, the new chief technology officer of AGFA HealthCare, who signed on this summer, asks himself, his team, and his clients this question every day.
“It really is tough out there [for radiologists],” says Brown. “But it’s also a privilege to be the person leading the expert team that’s helping to make radiologists’ day-to-day lives a little easier.”
“We’re focused on key demographic trends that are going to shape the industry for a decade or more.”
Brown is well-equipped for the task, having been dedicated in the worlds of imaging devices and software for more than 20 years. As one of the newest executives to join AGFA, he brings with him not only a sharp eye for identifying challenges, but also a keen understanding of how R&D teams can play a key role in developing new innovations to address them.
“We’re not looking for the ‘flavor of the day,’” Brown says. “We’re focused on key demographic trends that are going to shape the industry for a decade or more.”
So what are the most important industry trends that AGFA is noticing, and how is the company’s IT team finding solutions that can shift the industry to a more positive direction? Here, Brown shares his observations.
1. Fewer radiologists, more work
The trend: An aging population, combined with a shortage in the radiologist workforce, means that radiology exams threaten to overwhelm healthcare systems, radiology departments, radiology practices and imaging centers.
Solution: Use intuitive tech tools to maximize each radiologist’s efficiency and optimize flow by removing time-intensive tasks and obstacles.
“The population of seniors ages 65 and over—the people who use imaging most—is growing nearly 14 times faster than radiologist trainees are entering the workforce, as we see from RSNA data,” Brown says. “So we need to provide as many tools as we can for radiologists to be more efficient.”
With efficiency front and center, AGFA’s Enterprise Imaging Platform is all about minimizing distractions, putting technology to work so that radiologists can finally focus on their craft: reading images and creating meaningful reports that facilitate patient decision-making and care.
Simply put, AGFA EI offers “all-in-one” functionality that puts the images, information and tools that radiologists need to do their jobs right at their fingertips. One system, one login paired with built-in communication tools that mean radiologists can stay in and maintain their flow—even when they need to view additional, prior images, or to talk to a radiographer, ordering physician or surgeon.
In another major timesaver, AGFA EI’s workflow optimization puts the right cases in front of the right experts and prioritizes urgent and subspecialty cases, so radiologists don’t have to spend precious time deciding what needs to get read next.
“Whether it’s the customizable, rules-based workflow, dynamic hanging protocols, or automated case distribution, we are focused on putting the power of AI in the hands of the radiologist. AI is very important to advancing workflow, but it has to be AI that’s easy for radiologists to use.”
These innovations are important, says Brown, but it’s equally important that they’re done in a carefully considered way that genuinely helps remove some of the burden from radiologists. This is where the benefit of platform technology comes in. The platform provides the ability to standardize meta data, thus forming a consistent foundation for innovations such as Augmented Intelligence.
“Whether it’s the customizable, rules-based workflow, dynamic hanging protocols, or automated case distribution, we are focused on putting the power of AI in the hands of the radiologist,” he says. “AI is very important to advancing workflow, but it has to be AI that’s easy for radiologists to use.”
2. Remote reading
The trend: More radiologists are reading remotely in a post-COVID world.
The solution: Ensure that radiologists can quickly and consistently access high-quality images—both currents and priors—from anywhere.
AGFA’s Enterprise Imaging Platform offers the same access to the same high-quality images no matter where a radiologist is reading from. And as AGFA’s R&D team prepares to introduce a web version of their desktop, they’ll make global access to images flow even better.
“We’re working towards our vision where our web client and our diagnostic workstation are one and the same,” Brown says. “That enhances the ability of any authorized person, from any device, to be able to read right where they are. It could be an overnight radiologist who is reading on the opposite side of the country – or the opposite side of the globe. We’re also taking a multi-service line approach with archiving can optionally be in the public or private cloud, that’s more robust in a distributed hospital environment. We want our customers to be able to make the most from their existing investments and make sustainable future investments, so we meet clients where they are.”
Additionally, patients can rest easy that their radiologists will have access to prior images and data, no matter where in the health system they were originally taken. That’s because AGFA EI securely stores patient images and data, whether on-premises or in the cloud, and does the real-time processing necessary to move it onto a radiologist’s screen, on-demand, when and where the radiologist pulls up the case.
“Keep in mind that approximately 80% of images are read by radiologists not employed by the healthcare system taking the images,” he says. “So that makes it especially important to have one enterprise imaging system that brings all the images and data together in one view. That starts with a VNA [vendor neutral archive], works across networks and consolidates images in the cloud to scale more easily. And going to a web version of the desktop enhances their ability to read wherever they are.”
3. Widespread provider consolidation
The trend: Increasing cost constraints have led to widespread M&A consolidation of healthcare providers.
The solution: Turn consolidation into an opportunity for higher quality, by allowing large networks to utilize their subspecialists on complex cases.
“We see a lot of consolidation in the U.S., where, mainly for cost reasons, it's difficult for small radiologist groups, imaging clinics, and small hospitals to stand on their own,” Brown says. “They’re getting bought out by larger groups, local hospitals, or national health systems.”
While the word “consolidation” can make some people cringe, the shift may actually be very good news for those who prioritize quality of care above all—if mergers are supported by the right technology tools to put their size to patients’ advantage.
“Rather than limiting a single health system’s expertise—think about an entire network of radiologists in which you can match the right specialist with the urgent image. Not only can this help expedite the diagnosis and treatment plan for the patient, it improves the work experience and satisfaction of the clinicians in the network.”
That’s because combining forces creates an opportunity for health networks—especially large, consolidated health networks with a distributed workforce—to automatically send complicated and niche cases to a diverse mix of subspecialty radiologists.
“Rather than limiting a single health system’s expertise—think about an entire network of radiologists in which you can match the right specialist with the urgent image,” Brown says. “Not only can this help expedite the diagnosis and treatment plan for the patient, it improves the work experience and satisfaction of the clinicians in the network.”
4. Disparate systems among consolidated facilities
The trend: Confusion about the best way to standardize systems and train staff after M&A consolidation.
The solution: Embrace openness and eliminate the hassle of siloed data by offering a vendor neutral archive (VNA).
Post-consolidation, health facilities are often left with major operational questions related to whether and how to standardize their systems. How should they consolidate their historical images in a way that they’ll still be available for radiologists to view? What type of training will be necessary to get users up to speed, and how will the facility allocate appropriate training time without falling behind? Should they wait until they can move all locations entirely to a single enterprise imaging vendor? The list goes on.
“Not only will we accept any kind of a DICOM image, but we’ve made the assumption that you can have our VNA, but you don’t have to have our reader. Or vice versa—you can have our reader, but you don’t need to be connected to our back-end: or server or our VNA.”
AGFA’s approach to addressing this trend is to fully embrace its vendor-agnostic, location-agnostic approach. Clients benefit from the straightforward integrations that solve the complex issues of resource allocation, culture, and the need to provide a continuous flow of patient imaging between multiple distinct groups.
“Not only will we accept any kind of a DICOM image, but we’ve made the assumption that you can have our VNA, but you don’t have to have our reader,” Brown says. “Or vice versa—you can have our reader, but you don’t need to be connected to our back-end: or server or our VNA.”
Indeed, many customers do take advantage of AGFA EI’s VNA even though they use others’ PACS. Some large, distributed networks even continue to use multiple vendors’ PACS after consolidation, simply because that’s what their radiologists are used to, and changing would be a big headache. The AGFA EI solution is deployed in modules so a health system can converge services according to their unique timetable.
AGFA’s reader can connect to all of them, still providing a single reading worklist customized for each radiologist, no matter where they’re sitting or what they’re using. After a consolidation, a new facility can be ready to start quickly, without having to change the entire infrastructure.
“I think that's really helped our clients as consolidations have accelerated,” Brown says. “It saves time and effort and helps keep the cases moving.”
This design approach allows us to deploy our system in a way that meets the radiologists’ needs, while also meeting the health systems budget. You can see that as we can utilize their existing investments, for example legacy PACS or VNA systems, we have deployments are wholly on-premises, fully in the cloud, and a hybrid that mixes these.
5. Increased financial constraints
The trend: Health systems want financial predictability as well as consistent value delivery.
The solution: Deliver unprecedented value on a dependable timeline—while making upgrades regularly but optional.
Although it can be tempting for many software companies to push back new releases to add ‘that one more feature,’ Brown understands the importance of offering new versions of software on a predictable, regular cadence that clients can depend on. He is establishing a schedule where the company will offer clients upgrades on a quick cadence.
“As a healthcare IT company, our processes are fit for purpose,” he says. “And part of that is mindset. Our product team stands next to clients, listening, asking questions, making sure we understand their needs and priorities. Our priority is developing new releases that are high-quality, stable and easy to upgrade—so customers will use them and benefit from them. We’ve had software stumbles in the past that we’ve learned from. We’re doing things differently now. That’s the benefit of moving to an agile development model.”
Turning challenges into opportunities
Through all these efforts and more, Brown believes that the pre-eminent challenges in the world of radiology can genuinely become opportunities for next-era innovation.
And he’s certainly the right man for the job. After getting his start as a software engineer and engineering manager, he became an imaging and software R&D chief. He’s made imaging devices better; now his charge is to make imaging IT the best it can be.
“That means doing development better,” he says. “It means being more agile and engaging and connecting engineers and clients, so that we can define the imaging IT roadmap that radiology needs—today and into the future.
Ultimately, Brown and his team aim to help every radiologist perform at the top of his or her license—spending their time analyzing patient images and information and less time searching for it—so that patients, radiologists, and those who hire them can continue to reap benefits, no matter how challenging the headwinds are ahead.