Q&A: Angelic Bush on AI, clinical decision support and Florida in July

2018 has been an especially busy year for imaging leaders, with technology evolving at a rapid rate and healthcare policies continuing to change with the times. At AHRA 2018 in Orlando, many of those leaders will once again unite to share ideas, learn, network and have a little bit of fun. AHRA’s president, Angelic Bush, spoke with RBJ about some of the biggest trends in radiology right now and what she and her colleagues have planned for the big show in Orlando.

Q: As you look over the radiology landscape in 2018, what have been some of the biggest stories of the year so far?

Angelic Bush: There is something I’m extremely excited about, and I think it’s going to change healthcare completely: AI. It’s funny, because AI actually stands for two different things in our industry right now, and both are game-changers. There’s artificial intelligence—actually using technology to drive interpretations—and there’s analytical information. 

There are times in medical imaging when something comes along that could change everything. There was the development of x-rays, for example. The first MRI. The first ultrasound. Both artificial intelligence and analytical information are like that as well. They are going to impact every single modality in imaging and other areas of imaging as well. They were the talk of the town at RSNA 2017 in Chicago last year, and it’s just the beginning.

Q: Do you think radiologists, and the imaging industry as a whole, are growing more comfortable with the idea of artificial intelligence as time goes on? 

There was some concern at first, some “oh my goodness” moments, but once the technology got in front of the physicians and the imaging leaders themselves, we realized artificial intelligence was just a new tool in our tool belts—and a pretty powerful one. It’s not going to replace the human eye, but it can help reduce some things that are inefficient in our current operation. 

Q: Why is analytical information so important to the future of radiology? 

I’m a bit of a data geek, and I think other imaging leaders are as well. Analytical information provides us with a bit of comfort. As we make changes in healthcare, we don’t want to just take a swing in the dark. We want to know that changes are based on data. Leaders want to know we are headed in the right direction, and we can’t truly do that without data. 

Q: Are there any particular issues imaging leaders are worried about right now?

The biggest things this year are appropriate use criteria (AUC) and the implementation of clinical decision support. The concept is brilliant, and you won’t find an imaging leader who disagrees that the concept is brilliant. But a lot of us have been confused about implementation, and nobody wants to implement such an important process and then fail. It would have a significant impact on hospitals, it could destroy physician relationships, and it could impact patient care. 

AHRA has actually made some huge headway on this, and I’m particularly proud of it. AHRA was able to organize the very first AUC stakeholder summit. Representatives from AHRA, CMS, the American College of Radiology, X12 and the National Uniform Billing Committee were there, among others. Vendors were there. We got everyone in the same room to talk through this problem. Nobody was arguing that we shouldn’t move forward, but we had to discuss the “how.” This was the first of many meetings, and now I think there’s a light at the end of the tunnel. 

Q: A recent AHRA survey found that most imaging providers are still in the process of updating their computed radiography (CR) equipment to digital radiography (DR). Do you have any advice or insight for leaders currently dealing with that transition?

I would advise imaging leaders to do the financial analysis and work out the impact of the potential 7-percent penalty that is at stake. You have to work out if the penalty is worth the implementation for your specific location and your specific population. Also, a new ruling from CMS indicated there would be no penalty if CR and DR are both used to image one patient—and the impact of that 7-percent penalty could be less now as a result of that ruling. 

Q: What’s new and noteworthy at this year’s annual meeting?

I’m personally very passionate about this show, and I’m very proud of our design team and our speaker selection committee. We just completed a member survey and found that more and more AHRA members are going into areas such as cardiovascular imaging and radiation oncology. So we’re growing in scope, and we wanted to make sure the topics selected for AHRA 2018 reflected that growth. We have speakers coming to address specific operational challenges in these other areas as opposed to solely focusing on radiology. Imaging is a part of other service lines besides radiology, and we needed to reflect that so that we could include everyone.

There will also be a lot of talk about length of stay this year and what we can learn about it from studying data analytics. Imaging can play a role in hospital length of stay, emergency department length of stay and more. We recognized that our members are being asked about length of stay at their hospitals, so we needed to look at that during the meeting in Orlando.

Q: What advice do you have for first-time AHRA attendees?

Bring business cards. Lots of business cards. The best advice I can give to anyone attending one of our conferences is: Talk to other people. Meet people. Make a new best friend. Whatever problem or difficulty one imaging leader is going through right now, another imaging leader has already gone through it and learned from it.

Even if you are a first-time attendee and you think you’re there just to learn, I can promise you that you have something of value to share with another attendee. We truly are all in this together.