Radiology’s Looming Labor Gap: How Emerging Technology Can Address this Labor Shortage and Better Serve Providers, Patients and Health Systems | By Evan Ruff, Chief Executive Officer and Co-founder, OXOS Medical

Within two years, the U.S. will have a shortage of 98,700 medical and lab technologists and more than 80% of health systems are currently reporting shortages in their radiology departments. More than half of the radiologists in the U.S. are 55 and older, and the flow of residents to fill the gap isn’t nearly big enough. The staffing shortage is even more acute among radiation technologists and in the U.K., 97% of radiology departments cannot meet diagnostic reporting requirements.

Patients, hospitals, imaging centers and outpatient facilities are feeling the squeeze, as the labor shortage causes longer wait times for imaging and delays results. Meanwhile, the healthcare system is experiencing a growing need for imaging for our aging population. A study presented at RSNA 2021 reported that the growth of the Medicare population outpaced the diagnostic radiology (DR) workforce by about 5% from 2012 to 2019. Meanwhile, Medicare reimbursement for imaging has decreased 25% over the last 16 years, leading to a lack of interest from students entering medical school and contributing to burnout for current practitioners and technologists.

These conditions demand novel solutions to close the gap and provide the support imaging teams need to remain efficient and effective and improve outcomes for patients. Fortunately, new technology and new operational and workflow strategies are beginning to alleviate the strain providers are experiencing. At the same time, they are expanding access by bringing x-ray capture out of the radiology suite directly to the point of care. These new technologies, which can be used in diverse environments by users with varying levels of training, combined with programs designed to increase the number of radiologists and technologists entering the field, promise to alleviate some of today’s current challenges.

New sites, new paradigms for care

Portable imaging technology that harnesses the power of advanced image processing, computer vision, X-ray detector improvements, easy ergonomics, and innovative X-ray tube architecture is delivering time savings and improving access. Enabling new sites for radiologic services and helping to support existing radiology staff promises to bridge the staffing gap. Across the board, healthcare administered outside of the hospital environment in freestanding sites such as ambulatory surgical centers is becoming more attractive to patients and insurance companies. The cost and convenience of performing procedures outside the hospital combined with the impact of the pandemic and Medicare’s ongoing expansion of coverage for outpatient procedures is hastening the shift.

Multiple use cases demonstrate success

X-rays are the most utilized imaging modality in an orthopedic surgical practice. Orthopedic surgeons use them for diagnosis and post-operatively to inform treatment and confirm recovery. The ability to obtain rapid diagnostic X-rays at the point-of-care is also improving workflows and improving patient satisfaction.

Portable X-ray technology isn’t confined, of course, to the four walls of a medical practice. It’s even found utility in the highest echelons of professional sports. Today, if a Jacksonville Jaguars player suffers an injury that requires an x-ray, the team’s portable x-ray machine enables a sideline scan. Prior to its introduction, if a player was injured the medical team had to bring him off the field down a long tunnel before eventually reaching the radiology room under TIAA Bank Field. By one estimate, the roundtrip journey could take 25 minutes, so even if the film was negative and the athlete could have returned to play, considerable game time was lost. Now, a player can be scanned on the field, reducing a player’s absence from several series to several plays. Portable x-ray is also being used in remote and low-resource areas that depend on mobile care to provide access.

The future of X-ray

In the next ten years, portable imaging is also expected to change how injuries are treated at the work site and at home. Soon, if patients fall and hurt themselves at home or at work and are concerned about a fracture there will be alternatives to going to an urgent care or emergency room and spending thousands of insurance dollars. If they are at home, rather than spending half of their day at a facility, they could order an urgent home health visitation by a mobile provider via telehealth. Mobile image capability devices can obtain rapid diagnostic X-rays and then access an available radiologist and orthopedic surgeon to triage the injury and provide appropriate care and follow-up.

New technology lightens the load for radiology departments and distributed care environments

The clarity, safety, accuracy and speed of these portable devices are enabled by various engineering innovations as well as artificial intelligence, which helps to make the machines smarter and easier to use. This is dramatically shortening the learning curve and pushing a variety of healthcare providers to competency while lowering the dose of radiation per image. AI is able to sense where adjustments need to be made to improve the image that’s being captured and guiding practitioners through what they’re looking at, allowing someone who has never used a medical imaging device before to accurately capture an image the first time. Radiologists are also using AI-assisted image reading, which can scan for abnormalities and flag them for further assessment. While the FDA still requires a doctor to give a final reading, it has already approved over 400 algorithms that can scan for various diseases with an 80% to 90% accuracy rate. Radiology accounted for 87% of new FDA-approved AI/ML devices last year, and 79% of new devices in the first half of 2023.

Transforming care

The healthcare industry is undergoing a massive transformation as care providers increasingly work to connect with patients outside of hospitals. Putting safe, powerful and simple X-ray technology in the hands of urgent care centers, family practices, sports teams, home care and international mission operations is transforming healthcare delivery and lightening the load for overburdened radiologists and technologists. By enabling easier capture of images that could be difficult to obtain using large, fixed equipment, portable x-ray at the point-of-care is addressing the growing needs of orthopedic and radiographic professionals across all care scenarios. Broader use of teleradiology, shared imaging services and third-party providers is also helping to offset growing workloads. Forward thinking healthcare organizations are also encouraging newly retired radiologists to return to work part-time and launching outreach campaigns to target medical students to consider radiology careers. Expanding access to x-ray is vital to a high-quality healthcare system and radiology practices that prevent long wait times and provide high-quality care will be best positioned to experience the greatest success.

About Evan M. Ruff

Evan Ruff is a serial entrepreneur with a history of building high technology products, bringing a strong engineering-driven approach to OXOS Medical. Evan holds a Bachelor’s Degree in Computer Engineering and a Masters of Business Administration from the Georgia Institute of Technology. Evan is a member of the Medical Device Manufacturers Association (MDMA) Cybersecurity Working Group and leads the business, IP, and technology functions of the company.

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