MRI : Magnetic Resonance Imaging : Thumb MRI

By Lauren Pigeon

Thumb MRI Center in Cass City, Mich., is taking aim at the fifth leading cause of death in the United States today: medical mistakes.

Medical mistakes cause more deaths—approximately 98,000—in the U.S. than breast cancer, highway accidents or AIDS, according to an independent report from the Institute of Medicine, an arm of the National Academy of Sciences.

These mistakes cost the nation almost $9 billion a year.

To tackle medical mistakes, Thumb MRI, a freestanding MRI center that services a large, rural population of Michigan, has taken a twofold approach.

First, Thumb MRI has replaced its old MRI system with a new scanner to increase the quality of images.

In addition, the center is collaborating with AIdentity Matrix and American Diagnostic Medicine (ADM) to integrate a patented artificial intelligence technology to increase the quality of healthcare the center provides and to decrease medical mistakes.

New system

“If you take a look at the state of Michigan, it’s shaped like a hand. The MRI center is in the area of the thumb,” said Ram Gadam, MD, medical director of Thumb MRI Center and AIdentity Matrix. “It’s a very rural community with a lot of small hospitals.”

These small hospitals got together to create one MRI center because it would have been too costly for each hospital to have their own center, explained Dr. Gadam, who is also the chairman of the department of radiology at St. Mary’s of Michigan, Saginaw, Mich.

“We’re in a small town of 1,800 people, but we see about 25 to 27 patients a day,” said Anand Kancherlapalli, president of Thumb MRI and AIdentity Matrix and partner of ADM.

With such a demanding patient volume, Thumb MRI recognized the demand for higher quality MRI testing. They met this demand by replacing their old, open, low-strength MRI system with a new High Field Vantage XGV Short Bore Scanner from Toshiba America Medical Systems, Tustin, Calif.

The new system allows for Dr. Gadam and the other physicians at Thumb to make consistent and confident diagnoses.

“It has a good signal-to-noise ratio which means the image quality is better,” said Dr. Gadam. “Because you have a better definition of the disease process, the image will be better. The better the image, the better the report. The better the report, the better the outcome.”

“It’s also much quieter than the old one,” added Dr. Gadam who has been in practice for 25 years.

Continual loop

With the new MRI system in place, Thumb MRI Center is also excited about its collaboration with AIdentity Matrix in developing and implementing its Artificial Intelligence (AI)-based technology which aims to reduce medical mistakes in diagnostic imaging.

The software standardizes and optimizes the workflow process, spanning the healthcare cycle by beginning with the referring physician all the way through to the final diagnosis and treatment.

The software provides a seamless environment with controls that allow for accurate reporting, verification of patient safety and cross validation of the information. The doctor can easily reference a vast database of clinical cases and prominent medical text during diagnosis. The software agent will provide a guideline to the physicians making them more aware of disease indications, when an MRI is appropriate, what to rule out and what the current reimbursement policies are in place. This will also help to eliminate unnecessary imaging exams that may cause the patient anxiety. There are several agents to the program each addressing a specific area of work but ultimately bringing them all together.

“We are trying to empower the full circle of the diagnostic cycle with knowledge. As the patient data goes through the cycle, the technology is validating that everyone involved is on the same page and knows exactly what is going on,” said Kancherlapalli.

“We want to make sure the referring physician has an understanding of when to order an MRI and what kind of diseases an MRI could rule out,” said Kancherlapalli. This aspect eliminates unnecessary imaging exams that may cause the patient anxiety.

When the referring physician recommends the patient for an MRI exam, the technology next links the receptionist into the software. This facet of the technology aids in the receptionist’s responsibilities, such as scheduling, billing and insurance information, personal information and safety requirements. With the ability to monitor scheduling, the technology avoids schedule conflicts, including times that have been reserved for the maintenance of the machine. The system can also recall any past information stored for the specific patient, reducing the number of redundant questions and minimizing the number of mistakes possible when the receptionist enters data.

Tech and MD aspects

The technologist and radiologist agents provide a comprehensive tool that enables them to make informed clinical decisions. The software agent creates a comfortable environment for the radiologist and technologist to work quickly and accurately.

Based on information the reception has already entered into the shared database, the software will pool the patient data and create a custom-designed data entry form for the technologist to ask the patient. If the patient has been to the facility before, the software will auto-fill the information, allowing the technologists to skip repetitive questions.

Once the patient information is complete, the software will suggest the best scanning protocols based on the patient information, the facility’s MRI system and any past exams the patient had. This can be used as an onsite tool at the location of the scan or remotely through a secure network connection across various platforms.

Dr. Gadam is most excited for the radiologist agent of the technology.

“I’m very excited about it. We should be able to implement this technology and see how much of a difference it will make,” said Dr. Gadam.

As a radiologist, consistency is very important to Dr. Gadam.

“There is a safeguard in the system so that I get consistent images. This will prevent calling the patient back for repeat studies, the system has all the tools to give me a good, detailed history of the patient. The better the patient history I have the better I can tailor my report to the patient,” said Dr. Gadam.

The software also enables the radiologist to call upon previous studies the patient may have had as well as past and present conditions of the patient.

“We’re working on making it easier for the radiologists to do their readings,” said Kancherlapalli. “We’re adding voice recognition and annotation tools so all they have to do is click on the screen and annotate the image areas specific to each finding or impression.”

In addition, once the study is completed, it will be added to the database for future reference, almost creating a reference book for each patient in a virtual library. Within this virtual library, the software provides a comprehensive search engine in which the radiologist can request a specific query. In return, the software will search the library and produce relevant results of accurate images with annotations and histories.

Once the radiologist reviews and signs-off on the report, the software moves the report forward to the other appropriate agents in the healthcare cycle, including the referring physician.

“This closes a gap in communication and gives me good feedback. It will help me become a better radiologist,” said Dr. Gadam.

The future and beyond

The software should be completed in about eight months.

“The crutch of the whole technology is pretty much developed. Now we have to start the validation process: Does the doctor feel happy using the software? How user-friendly is it? We already have vendors interested in it but we want to make sure it is 100 percent first,” said Kancherlapalli.

While the technology is being developed at an MRI center, the creators do not wish to limit the software to strictly MRI applications.

“Our idea is to start with MRI and expand into different aspects of radiology: first MRI and then go into CT, nuclear medicine and the whole nine yards,” said Dr. Gadam. “Then eventually go into the other aspects of medicine, such as internal medicine or surgery.”

In fact, technology-transfer is already underway into the nuclear cardiology domain.

For now, this technology serves Thumb MRI Center in its battle against medical mistakes by provided information from the past and present to everyone involved in the healthcare cycle.

“Needless to say, the more information we have, the fewer mistakes we will make,” said Dr. Gadam.

Lauren Pigeon is an editorial assistant at ADVANCE. She can be reached at lpigeon@merion.com.

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