Emergency Chest CT’s Amazing Growth

“If bedside ultrasound really is the stethoscope of the 21st century, as so many have suggested, perhaps we should use it as such. I’m not aware of any randomized, controlled trials that show an increased survival rate when I listen to my patient’s heart, but I’m going to do it anyway. . .”

Louisiana State University at New Orleans emergency medicine professor, Christine Butts, MD, in response to a study that found POCUS did not benefit shock patients. Safe to say, she plans to keep using POCUS.



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The Imaging Wire

Shimadzu Acquires
Shimadzu Medical Systems USA expanded its northwest US direct sales and service presence with its acquisition of CORE Medical Imaging (CMI). CMI has an X-ray/RF/Angio sales and service presence across Washington, Oregon, Idaho, and Montana, and appears to largely focus on its Shimadzu product line, while maintaining partnerships with Canon, Konica Minolta, and potentially other brands. This acquisition isn’t a major surprise, coming about eight months after Shimadzu revealed plans to grow its North American medical business by a whopping 26% by 2020 (hard to do that organically), suggesting that additional channel acquisitions may be coming from the traditionally partner-centric company.

China, The AI Adoption Leader
A new report from Boston Consulting Group (n=2,700 companies, 7 countries) positioned China as the clear global corporate AI adoption leader, with 85% of all surveyed Chinese companies either using or piloting AI within their business processes (vs. 39% to 51% in all other countries). BCG attributed China’s AI adoption leadership to the effectiveness of its national AI initiatives and Chinese companies’ disruption-friendly management styles, noting that China leads AI adoption across all major industries (all 83% to 89%), while most other countries have inconsistent industry-level adoption rates (e.g. US’ industry adoption rates range from 41% to 73%). There’s barely any mention of healthcare in this report, but the massive adoption of AI among Chinese companies paints a telling picture of China’s AI head-start, which appears to be taking place both on the supply and demand sides of artificial intelligence.

The US Pays Way too Much for Healthcare
Research from Johns Hopkins Bloomberg School of Public Health found that US per-capita healthcare spending reached $9,892 in 2016, surpassing the country with the second highest-spending (Switzerland) by 25% and beating the Organization for Economic Cooperation and Development (OECD) median by 145%. Between 2000 and 2016, US healthcare spending maintained an OECD-leading 2.8% annual growth rate, significantly outpacing the US’ 0.9% GDP growth rate and bringing US healthcare spending to 17.2% of GDP, well above the OECD median of 8.9%. The researchers clearly blamed skyrocketing US healthcare costs on a pricing problem, suggesting that “it’s not that we’re getting more; it’s that we’re paying much more.”

Radiology Partners Hits Vegas
Radiology Partners (RP) expanded to Nevada for the first time, signing a partnership with relatively large Las Vegas-based practice Desert Radiology (70 radiologists, 11 imaging centers, 12 hospital contracts). Desert Radiology continues RP’s notable expansion run, that included partnerships in Arizona, Illinois, Texas, Louisiana, California, and Florida since landing a $234m capital investment in March 2018 (that’s 18 states for RP so far). The partnership also serves as another sign of a changing practice mix in Las Vegas, which welcomed Mednax in October when it acquired Radiology Specialists (25 rads).

Emergency Chest CT’s Amazing Growth
New research revealed massive increases in emergency department chest imaging procedures between 1994 to 2015, especially chest CT imaging, due in part to greater availability of CT scanners and increased pressure on physicians to quickly diagnose patients. Using Medicare data from the 20-year period, the study found that ED utilization of chest radiography increased by 173% (4.9% CAGR) and chest CT imaging increased by an amazing 5,941.8% (21.6% CAGR) per 1,000 patients. Chest imaging posted similarly astounding increases per 1,000 ED visits, with chest radiography increasing by 81% (2.9% CAGR) and chest CT growing by 3,915.4% (19.2% CAGR). There’s been plenty of recent studies on emergency CT overuse, and although this study didn’t make many judgements regarding how much of this growth was due to unnecessary scans, it does make all the talk of emergency departments’ growing reliance on imaging feel a lot more real.


The Wire

  • Here’s one way to help improve the efficiency of all these ED CTs. A team of New York researchers found that by introducing a dedicated emergency department CT exam expeditor, they were able to reduce the time between CT order and CT workup from 63 minutes to 41 minutes (-35%) and cut the time between CT order and CT exam from 116 minutes to 91 minutes (-22%). The creation of a CT expeditor role also allowed the ED to add one CT acquisition per day (31 to 32) and significantly reduce patients’ length of stay, which was 4% lower for discharged patients and 12% lower for admitted patients.

  • Japanese conglomerate, Marubeni acquired an unspecified stake in US-based AI medical imaging developer, Enlitic, as part of their new business alliance to develop and commercialize deep learning diagnostic systems for the Japanese market. Marubeni will focus on licensing and promoting Enlitic’s chest X-ray diagnostics solution in Japan and help the company develop an online platform capable of data collection, management, and remote diagnosis.

  • EOS imaging released its FY and Q4 2018 financial results, revealing a 5% drop in annual revenue of €35.3 million (Q4 -19% to €9.8m) due to lower sales in EMEA and Q4 sales delays. On the bright side, EOS highlighted a 34% increase in recurring maintenance contract revenue to €7.9 million due to its growing installed base, while suggesting that many of its delayed 2018 deals will help bolster its pipeline heading into 2019.




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