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LIVE FROM RSNA: Radiologists Need to Get Out of a “Radiology-Centric” View of Practice

December 2, 2015
by Mark Hagland
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John P. Karis, M.D., a Phoenix neuroradiologist, shares his perspectives on what radiologists need to do, going forward into the new healthcare

John P. Karis, M.D., a neuroradiologist, is the director of MRI neuroradiology at the Barrow Neurological Institute, located in Phoenix, Arizona, the world’s largest neurological disease treatment and research institution, with an average of 100 neurosurgical operations per week, according to the organization’s Wikipedia entry. Dr. Karis, who with fellow radiologists in the Phoenix area has been associated from the start with DICOM Grid, the Phoenix-based “healthcare SaaS company dedicated to making digital medical image management accessible to all, from anywhere,” using a cloud-based suite of solutions, according to DICOM Grid’s website. Dr. Karis, a scientific adviser to DICOM Grid, met with HCI Editor-in-Chief Mark Hagland in DICOM Grid’s booth at the 2015 RSNA Conference, sponsored by the Oak Brook, Il.-based Radiological Society of North America. Below are excerpts from their interview.

What is interesting to you at RSNA this year, as you look at this year’s exhibit hall?

A lot of my time has been focused with DICOM Grid, but my impression of the exhibit floor here at RSNA, per a lot of radiology right now, is that, in most things, the changes I’m seeing are fairly incremental. There aren’t a lot of revolutionary-type, earth-shattering things going on. And I think that even in the cloud space that DICOM Grid is particularly interested in, what we’re doing is incrementally improving. The most important change to me is a change in attitude. Four or five years ago, there was a lot of hesitation about putting data into the cloud, per safety, responsibility, control, whose information it is—that many hospitals were just not psychologically ready to turn off their virtual private networks and go to the Internet.

John P. Karis, M.D. at the RSNA Conference

I believed that would be the case in 2004-2005, which is why a bunch of doctors at Barrow formed the company. And so the physicians involved in DICOM Grid were total believers that this was the way images would be shared and managed in the future. We were just a decade on the early side, per the market. But the most striking thing to me, even if you go around to the big vendors, everyone’s talk about the cloud, everyone’s talking about image exchange. So what is in DICOM Grid’s wheelhouse, has gone from people saying, “Yeah, that’s really cool, something for the future,” to, “If you’re not doing this, you’d better be.” And DICOM Grid is in the enviable position of having put a lot of time and thought into what to do and how to do it.

How is your world changing as a radiologist these days?

Traditionally, it’s been very difficult for different radiology enterprises to exchange information. Putting films on trucks, or CDs into FedEx and UPS packages, or literally taping them onto patients’ chests, that’s the norm that we’ve been emerging out of, in the industry. And there’s still a tremendous amount of that kind of thing that’s still going on. But the idea of moving image data around on a CD that can get lost or broken, is expensive to generate and is just not the optimal way to be doing things, was just so clear to us a long time ago.

How is the electronic sharing of images changing radiology practice now?

It doesn’t always make it easier; sometimes, clinically speaking, it actually makes it harder to have the comparison images. But it makes it better for the patients. And it reduces the likelihood of re-imaging. To me, it’s more about better healthcare, and reducing costs, both of which are important to us. If we’re trying to do value-based care and are doing what we’re supposed to be doing, it’s not about whether one extra read was easier, it’s about, was it better? So, what we’re getting is more accuracy of interpretation, and better care delivery.

How can radiologists better prove their value in the new healthcare? Some are saying that radiologists need to get out of the reading room more.

I think it’s not about being in or out of the reading room; it’s about exchange of information. One of the things about having a cloud-based architecture is that it’s not just about the radiologists. It’s important that the radiologists have an efficient environment to work in, so they can make a living. But it’s about the referring physicians having access to information and exchange of information. Web allows you both to look at the same images at the same time, and consult in that way.

What comes out of that is a better consult, then, correct?

Yes, hopefully, and a more efficient exchange of information between radiology and the clinical side. The primary reason I’m so enthusiastic about DICOM Grid is that it’s a product that from its inception was designed for combined radiologist and clinical physician efficiency. The primary goal has always been greater efficiency and better communication between

What must radiologists do in the next several years?

We need to get away from a [radiology-]centric view of our practice, and strive for the big-picture goal of how we can provide better, more efficient care for patients, and improved value, and if we can do that and do it well, our practices will thrive. Unfortunately, some people think that if you enable image exchange, you’re helping your competitors. Ultimately, it is a competitive advantage to provide better care; and if you do that, everything else will fall into place.