Radiologists becoming more like information managers and image processing specialists.Dr. Pablo Valdés is vice-chairman of the Spanish radiologists’ society – Spanish Society of Medical Radiology (SERAM).In this interview with Everything Rad, he looks at the not-too-distant future of radiology. He proposes that innovations such as artificial intelligence, robotics and Big Data will require radiologists to transform to information managers and specialists in image processing who will contribute decisively to patient well-being and the sustainability of the health care system.
ER: What do you think will be the biggest change to occur in the work of radiologists in the future?
Dr. Valdés: In recent months, we’ve been talking a lot about the great innovations in information systems, artificial intelligence, robotics, Big Data, and other advances that many see as a threat to our profession. However, radiology is a profession that, throughout history, has been able to adapt to all technological innovations, integrating them into our daily tasks.
In the not-too-distant future, the role of radiologists will change. They will probably be much more like information managers and image processing specialists. It will be increasingly less relevant to focus only on one phase of the process, such as those who only write reports without taking care of other important points such as the suitability and quality of the test, the quality of the report, etc. We are already seeing this in today’s medical care, where the most valued radiologists are those who solve the problems of clinicians and patients.
ER: What role does conventional radiography (X-ray) play in medical care in view of the development of technologies such as ultrasound or CT? Is it logical that analog X-ray equipment should still exist in hospitals?
Dr. Valdés: Conventional radiography, due to its speed and low cost, will continue to play a fundamental role in the diagnostic process, especially in certain situations or more restrictive financial environments. Conventional radiology equipment is very cost-effective: relatively inexpensive to buy, high performance, low expense to produce the study, and has few breakdowns. It is difficult to conceive of medical care without the role of conventional radiology.
However, the concept of non-digital radiology is an anachronism. Mixed solutions, with conventional rooms and indirect digitization (CR) systems, can be considered as a transitional solution. But they should be replaced by direct digital radiology rooms as soon as possible.
ER: What is the biggest challenge facing the specialty in Spain?
Dr. Valdés: Radiology is a prestigious specialty which is highly valued and plays a very important role in the healthcare system of our country. Like all fields of medicine, it faces the problem of the economic situation. This means that investments in equipment have stopped for years. The technology park is in need of a major update. If you want powerful radiology, it’s necessary to make an investment that is not always included in the budgets.
Also, the attractiveness of radiology plays against it in the area of what we call “threats”. Some specialists want to include certain imaging techniques in their diagnostic processes, and they want to do them directly. The problem in many of these cases is that the work of an image specialist is replaced by that of another specialist, who may well be excellent in his field, but has little training in imaging techniques.
The most typical example is ultrasound, where specialists perform explorations after receiving training based on courses lasting only a few days. This not only poses a threat to the specialty of radiology, but also to the health system since it causes a significant decrease in the quality of care.
ER: How can radiology contribute to making the healthcare system more efficient?
Dr. Valdés: Radiology is one of the fundamental factors in making the health system efficient. It is rare for a patient to be treated without first having one or more imaging examinations. And a very important percentage of the cost of healthcare is attributable to diagnostic imaging tests. The participation of radiologists in deciding what tests to perform and in what order is the only way to optimize the costs. And this implies not only the commitment of the radiologists, but also of the specialists who request the tests.
On the other hand, interventional radiology has an increasing number of advances that can replace invasive and costly procedures with more decisive and faster ones.
ER: What is the value of patients having access to their radiological tests through patient portals? What benefits can this bring to the system, the patient, and to the radiologists themselves?
Dr. Valdés: The citizens are the owners of their own medical history. Any tool that allows patients to have access to their history at all time and from anywhere not only means an improvement in quality, but also facilitates the work of any professionals who care for the patients at a different center.
For radiologists, this can be fundamentally important, since comparing a study with previous tests can be a major factor in establishing a diagnosis and avoiding new and sometimes more aggressive procedures.
Editor’s note: Read the blog on why computers and AI pose no threat to the future of radiologists.
Pablo Valdés is vice-chairman of the Spanish Society of Medical Radiology (SERAM). Dr. Valdés is also the director of the Radiodiagnostic Area of the Costa del Sol Health Agency, and is a recognized expert on radiology management and quality.