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LIVE from RSNA 2016: Radiology Thought-Leader Eliot Siegel, M.D., on What Value Really Means

November 28, 2016
by Mark Hagland
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Eliot Siegel, M.D. shares his perspectives on the emerging quest for value, at RSNA 2016

If the transition from film-based radiological practice to PACS- (picture archiving and communications system) facilitated practice that started nearly 30 years ago was historic, the radiology world is on the threshold of a far more profound set of changes, Eliot Siegel, M.D. believes. Dr. Siegel made his comments at a media breakfast sponsored by the Amsterdam-based Philips, on Monday at the annual RSNA Conference, sponsored by the Oak Brook, Ill.-based Radiological Society of North America, and being held at Chicago’s gargantuan McCormick Place Convention Center.

Dr. Siegel was one of several speakers at the Philips media breakfast on Monday morning. At that event, Philips executives explained in some detail about their strategic goals for the company, echoing what other vendor executives have said about the present moment in radiology. “We have to be faster, easier to use, and more reliable; we have to change the economics around equipment,” said Rob Cascella, executive vice president and CEO of Philips Diagnosis and Treatment. “So we’re building in things like intelligence, decision support, and predictive analytics. We want to make the clinician more effective. And from an operating perspective, we want to make the group more effective.”

And, following the roundtable discussion involving Philips executives and radiologists, including Dr. Siegel, Yair Briman, the Haifa, Israel-based senior vice president and general manager of Healthcare IT Philips, told Healthcare Informatics Editor-in-Chief Mark Hagland that “We see the opportunity of how much more value we can add to patient care. So the revolution” that’s happening right now, Briman said, “is really in moving from the hardware—though we continue to innovate there as well, for example, around SPECT-CT—but it’s really in the information and in how you manage that information. We need to help radiologists become more effective, especially in their use of time. So being able to provide radiologists at the point of practice with a range of protocols for diagnostic image analysis, all fully automated, will be one of the areas in which we can provide tools”—such as for calculating the volume of tumors—“that will improve not only productivity but also clinical quality.”


Eliot Siegel, M.D.

At the media breakfast, Dr. Siegel, who is the chief of imaging at the VA Maryland Healthcare System, vice chair of radiology at the University of Maryland School of Medicine, an adjunct professor of computer science at the University of Maryland, and of biomedical engineering at the University of Maryland-College Park, noted that “This year marks the twenty-fifth anniversary of when we purchased the world’s first all-digital system. We had the first fully filmless digital imaging hospital system, the PACS. It was really cool just not to lose the films. Back then, that was a really major thing, though we take that granted today. We actually had our department enclosed in an enclosed glass cage, and everyone came in to see the radiologists reading at stations. Twenty-five years later,” he continued, “I’m not sure we’ve achieved all the things we had hoped to. Sure, we have images anytime and anywhere we want to. But we were hoping we could really use the computer and coordinate with the electronic medical record, and really have the radiologist be a consultant.”

What’s more, Siegel emphasized, “The radiologist’s role is not just to make findings, but to have the judgment. Computers can do some findings, but the radiologist needs to put all those things together. And it’s a complex nexus of information we need—using our judgment, combined with the findings on the image. So what I want from the next generation of systems, is to be able to take advantage of all the amazing things we had hoped for 25 years ago, with a whole new generation of information systems to support us. So I was excited to work with Philips to try to bring this to our healthcare practice.”

Among the issues Dr. Siegel sees as persisting, most are around workflow and clinical decision support of some sort or another. “Some of the challenges I have in my own job,” he said at the media breakfast, “number one, we have many different workstations we need to do my job, I want to consolidate that. I want to be able to combine genomic data and personalize the way I take care of patients, and have that information in front of me, information from the EMR but also from other sources. And I want that information available in real time. As I go to read a study, I want all that clinical information available at that moment. It’s that ‘mission briefing’ concept that was mentioned a few moments ago. And I want to be able to deal with the complexity and volume of information systems right now.”

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