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Predictions for 2020 by Digital Doctor

Posted Oct 23 2008 1:34pm

Digital Doctor has posted several incredibly eloquent messages on AuntMinnie.com. Here are his predictions for 2020, which I suspect will turn out to be right on target:




The Future of Medical Imaging - 2020’
By: Digital Doctor
Sat 31 Dec 2005


My Predictions for 2020!


Government Regulations
In the United States, we will face a healthcare CRISIS on or before 2017 due to a lack of funding for Medicare and Medicaid. As Medicare and Medicaid are the "insurers" for approximately 30% of all medical care in the United States, you can perhaps only imagine the potential for havoc. The United States CARE Act will be passed prior to 2012, which will mandate federal registration of radiologic technologists. PACS Systems Analyst (a radiographer with minimal certification in PACS), PACS Administrator and PACS Manager will become recognized growth opportunities for radiographers. Registration will be required as part of the CARE Act. Many clinicians will truly question the necessity of radiologists (but not for the first time) and a political struggle will ensue for the future of medical imaging. Ultimately, radiologists will win for several reasons despite the overwhelming anti-radiologist movement. Radiologists will put more weight behind the radiographer role as well so that the two professions will be inseparable to better support their own role.


Expansion of Services
Medical Imaging will, of course, become an even more integral component of healthcare as (in the United States) utilization will continue the trend of expansion of 7% every year. Medical Imaging will assume as much as 25% of total hospital revenue on average.


Expansion of Roles
The Radiology Practitioner (introduced in 2003) will become an essential role in the United States due to expanded utilization of services and a reduction in reimbursement. Physician Assistants have been assigned to Radiology Departments since least 1995, which I would argue fulfills a similar role, as both the Radiology Practitioner and Physician Assistant are "physician extenders." The Radiology Practitioner will require a Masters Degree and two years residency (in addition to four years practice and registration in a Medical Imaging specialty).


Technology
The "One Touch" scan will revolutionize technologist workflow. Technologists will be able to focus attention on patient care and post-processing. OLED monitors (displays) will be the predominant technology of the day; however, OLED will soon be replaced by 3D Holographic displays which will offer the first "true" 3-Dimensional views of the human form in medical imaging.
"Personalized Medicine" (the most overused medical "buzz" phrase of the current decade) will finally be a reality at about the same time as healthcare in the United States nears collapse. Driving "Personalized Medicine" will be the introduction of several new "multi-modality" scanners. An “Omni Scanner” will be introduced that is able to perform diagnostic radiographs, Computed Tomography, as well as Magnetic Resonance and Nuclear Medicine scans.


TRIP (Transforming the Radiology Interpretation Process) by SCAR will become an extended initiative. By 2020 radiologists will interact visually, verbally and tactilely with PACS (renamed Medical Imaging Informatics in 2008). The radiologist will don gloves that will act as a virtual keyboard, a mouse and a multimedia controller (think the "Shuttle Pro" by Contour Design) "all-in-one." PACS systems will offer, "Visual memory cues" (not CAD) that will act as mnemonic prompts for radiologists and clinicians to remember specific patients and abnormalities. PACS will track and respond the eye movements so that visual fixations will result in image zoom and pan or will activaate functions upon which the user has a visual fixation.


AN ENTIRELY NEW MODALITY WILL BE INTRODUCED which will assume much of the workload of Computed Radiography and Digital Radiography. The new modality will not utilize ionizing radiation as a means for imaging. The new modality that will (possibly) continue to be known as Digital Radiography will undergo the most dramatic changes, as "unlimited" radiographers will utilize equipment that is more similar to Computed Tomography than Computed or Digital Radiography. Radiography Equipment will become much more portable so that the "Radiography Suite" (not the portable machines of today) will be portable. Computed and Digital Radiography will often acquire tomographic images from which 3D images will be automatically constructed by the modality. Computed Tomography will "top off" at 2048 "slices" which will become the new "unbreakable barrier" for years to come. Computed Tomography will automatically generate any required MPR, MIPS and even 3D volumetric series.
Nuclear Medicine and Magnetic Resonance (and likely Computed Tomography to some degree) will be the true driving force of the "Personalized Medicine" trend. Nuclear Medicine, in particular, will lose the moniker "Unclear Medicine" as images will begin to resemble the image quality captured in the 256 "slice" Computed Tomography images of 2008.
Computer Aided Detection will become so ubiquitous that CAD will be a standard feature on every modality. Every modality will utilize CAD for nearly every conceivable procedure that will increase in-office utilization of Cardiologists and nearly every medical specialty group.
Structured Reporting will become a reality and will drive major changes to the workflow of radiologists. In fact, Structured Reporting will be hailed as the "saving grace" of Radiologists. The innovations related to Structured Reporting and CAD will so alter the job function of radiologists that the profession of radiologist will either disappear (not likely) or become more interventional (especially as radiation therapy and nuclear medicine take on many new roles) or radiologists will offer "value added interpretation" (very likely).


Educational Trends
In response to the CARE Act and technological innovations the minimum educational requirement for radiologic technologists will be an Associates Degree (two years post primary school). More offerings of advanced degrees will be available for technologists seeking to specialize. Magnetic Resonance will have been recognized as a "primary modality" by the ARRT before 2012.


Even more COOL stuff on the horizon in 2020
BEYOND SIMPLE IMAGE DATA...Radiologists will utilize tactile and auditory senses by donning a suit that will provide additional sensory data to perform diagnosis - this data will be derived from image data (or data collected during the scan). Surgeons and Interventionalists will be able to utilize this data to perform remote surgeries. WAVELET COMPRESSION utilized by nearly every PACS and modality will be replaced very soon with "Fractal Compression" which will finally compensate for the overwhelming data sets generated.

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