In healthcare, efficiency and patient-centered care stand as pillars for institutions aiming to deliver optimal services. In radiology this means faster access to medical imaging rather than being referred to other locations, speeding up turnaround time and improving accuracy to reduce the need for additional imaging exams. Duly Health and Care in the Chicago suburbs is among a growing number of outpatient providers using high-end computed tomography systems to offer patients better, faster and more effective service.
"It's really providing the care that is convenient to patients and doing it in the outpatient setting through medical office buildings," Nasir Siddiqui, MD, the chair of radiology at Duly, explained in an interview with Radiology Business. "Seeing our providers—and then conveniently getting in to be imaged efficiently, and with our radiologists reading the studies and reporting them directly with the providers—is seamless and efficient and really optimizes patient care."
The versatility of Duly's CT usage spans various medical needs, from routine outpatient imaging to oncology follow-ups, fracture care, MSK work, and even lung cancer screenings. However, a significant component lies in their ability to cater to immediate or urgent care imaging. Sending patients to a hospital often adds time and is not convenient, which does not help with patient satisfaction.
"The efficiency of doing it in an outpatient center is easier for the patient. The wait times are shorter. The level of acuity is different, which allows us to bring the patient in more efficiently and diagnose them," Siddiqui said.
Why adopt AI-enabled CT in an office setting?
Siddiqui highlighted the advantage of providing CT imaging acutely, preventing the need to send patients to hospitals during critical times. This not only benefits the practice but also prioritizes high-quality patient care, ensuring prompt diagnosis and treatment. Duly purchased the GE Healthcare Revolution Ascend because of its versatility in various exam types and its artificial intelligence-enabled workflows, he said.
Efficiency reigns supreme in their approach, facilitated by cutting-edge CT technology that boasts an array of features designed to streamline workflows. Siddiqui acknowledged the transformative impact of these advancements, particularly in minimizing errors, optimizing patient positioning, and significantly reducing scan times. The seamless integration of smart, AI technology also further enhances the entire process, from protocol selection to dose optimization, centering patients on the bed, and ensuring consistent and high-quality imaging at a low dose, regardless of the patient size.
"One of the features that has been a significant benefit and change for us is the Effortless Workflow. It's really helping the technologists efficiently bring the patient in and optimize their positioning and scan quickly and efficiently. It has made it seamless for the technologist, minimizing the clicks and buttons that they have to pick through, reducing errors and providing a consistent product," Siddiqui said.
Reducing CT radiation dose using AI
The integration of AI-driven image enhancement also plays a pivotal role in minimizing radiation doses, especially for pediatric patients and those who undergo recurring oncology studies. The GE TrueFidelity image reconstruction algorithm uses AI to minimize radiation exposure by improving image quality of lower-dose scans.
Siddiqui said the AI enables them to image robustly with minimal dose, especially for pediatric patients. Duly is part of the American College of Radiology Dose Index Registry, which enables providers to track their own dose usage on CT and compare numbers against other health systems.
"We've seen our dose decrease significantly with the use of Ascend CT and TrueFidelity. Our CT doses were already low, but when you're talking about radiation, it's really about the principle of ALARA (as low as reasonably achievable). And with the CT coupled with TrueFidelity, you can really drive that dose down further," he explained.
Duly now routinely sees CT exam doses below 2 milliSieverts (mSv).
"Certainly for the oncology patients where you are repeating studies maybe on a monthly, three month or six month basis, that's where a radiation dose really matters. And certainly for the pediatric patients, you want to keep dose down as low as possible," Siddiqui said.
Spectral imaging helps reduce need for additional imaging exams
The implementation of spectral imaging that is part of the Revolution platform has not only enhanced diagnostic capabilities, but it also showcases a strategic shift in healthcare economics. By being able to diagnose patients comprehensively during the initial study, he said, Duly aims to reduce the need for further imaging, thereby minimizing costs and enhancing the overall patient experience.
Spectral CT allows the radiologist to view exams at different energies that enhance features of the image, he said. It also can manipulate various elements in the image, including iodine contrast, metals used in implants (thereby reducing or eliminating artifacts such as streaking), and calcium to see inside coronary arteries.
"We use a lot of spectral imaging with our GE products in the hope that, as healthcare moves from fee for service to a CMS capitation model, how do we minimize cost? And that's really the benefit of spectral imaging, where we can diagnose a patient on the initial study," he said.
The successful implementation of outpatient CT within Duly Health and Care's practice is a testament to their dedication toward improved patient care and operational efficiency. Siddiqui underscored the critical factors that made this advancement possible, including increased throughput, optimized scan and slot times, and a relentless pursuit of making imaging processes as effortless as possible, aligning with the evolving landscape of healthcare.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com