Managing to Succeed: What’s Ahead  
By Morris Panner  
Radiology Today   
Vol. 24 No. 4 P. 28

Five trends emerge to address medical imaging challenges. 

A perfect storm is threatening the future of medical imaging. The well-publicized shortage of radiologists is only expected to get worse as long-time professionals choose retirement and those burned out from the pandemic seek new jobs. Add to that an aging population and new detailed, complex imaging studies that require more time to evaluate, and it seems that there is little chance the black clouds over the radiology sector will clear soon—unless we take action.

Looking forward, there are five trends that could help minimize the impact of these long-standing challenges and improve the prospects for radiologists and patients alike.

#1—Radiology Goes Global
Within the next decade, the United States could face a shortage of 35,000 radiologists and other specialists. But this is not a uniquely American problem. For example, one report notes that while Europe has 13 radiologists per 100,000 population, the United Kingdom only has 8.5. Situations like this have resulted in a push for radiologists to work across borders to compensate for shortcomings in certain geographic areas.

RAD-AID is an example of one organization doing this. The nonprofit brings medical imaging to more than 30 countries, helping provide these vital services to low-resource regions around the world, in an effort to support global public health initiatives and patient care. Alliances are beginning to extend into the private sector, as organizations in various countries begin working together to keep pace with the demand for medical imaging.

#2—A Quest for Medical Expertise
With the shortage of radiologists, there is a greater possibility that patients will not live near medical professionals who have expertise in certain conditions. To provide the best possible care for patients, the medical community will need to avail itself of a larger resource pool. Subspecialists can be hard to find, so being able to go outside your practice to connect with those radiologists who have the most knowledge of complex diseases will ensure the most appropriate treatments for patients.

The use of digital imaging, the cloud, and the increased adoption of telehealth is making this quest for expertise a reality. It’s now easier than ever to share medical images and consult with specialists anywhere in the world, to bring health care to anyone who needs it—not just those who can afford it.

#3—Scaling to Support Health Care Consolidation
We’re also seeing a dramatic decrease in single-specialty radiology practices, as these smaller firms are merged into larger, broader groups. This trend is causing concern about the cost and quality of—as well as patient access to—services.

As radiology practices become larger, more dispersed, and deliver more services, they will need to be able to effectively scale their operations to ensure that they can manage the growing number of images. The cloud has become a valuable resource for meeting these practice demands, enabling virtually unlimited storage and access to images from any practice location by any radiologist. 

#4—Hybrid Cloud Adoption Underpins Mission Critical Work
There are different cloud models— public, private, and hybrid—available to radiology practices. Public cloud services leverage third-party servers and storage from companies such as Amazon Web Services and Microsoft Azure to deliver information via the Internet. Private cloud solutions are maintained by PACS solutions partners, with hardware and software dedicated to a single practice and residing with the services provider.

Hybrid cloud solutions combine on-site and public and private cloud services. It’s a solution large hospitals and health systems rely on as they gradually transition from onsite PACS infrastructure to more sustainable cloud-based services and storage models. The approach allows some of the IT infrastructure to remain onsite for certain applications while backup and data recovery are migrated to the cloud. The model ensures the constant availability of resources for the mission-critical, time-sensitive work performed by radiology practices, where downtime is not an option.

#5—Better Understanding of AI for Population Health and Reimbursement
AI innovation and adoption have occurred far more rapidly in radiology than in other medical specialties. There are now more than 20 radiology-related medical devices and AI algorithms approved by the FDA, which accounts for 72% of approvals in health care at large. The benefits of AI in improving quality while reducing costs, as well as easing the burdens on overworked radiologists by driving greater efficiency, are clear. However, what’s not clear is how medical imaging practices will be reimbursed for AI innovations.

While the CMS established payment for AI through the Medicare Physician Fee Schedule and the Inpatient Prospective Payment System, it is still a challenge for AI reimbursement in the current fee-for-service environment. The evolution to more mature, value-based payment models will make a stronger case for reimbursements for AI, as it is the foundation for achieving measurable improvements in quality of care at lower costs. This will also help patients achieve better outcomes and can support overall population health goals by leveraging actionable data to predict and reduce potential future complications.

While job openings in radiology and consolidation may be a long-term trend for medical imaging in health care, there are some bright spots thanks to technology, like the cloud and AI. These innovations in medical imaging are growing in use, and their impact will not only help existing radiologists work better and more efficiently, they can also help bring much needed radiology services—including specialty care—to patients no matter where they reside around the world.