The Role of Medical Physics in the Field of Radiology

MAHESH mahadevappaThis post was contributed by Mahadevappa Mahesh, MS, PhD, FACR, chair of the American College of Radiology (ACR) Commission on Medical Physics and Ashley E. Rubinstein, PhD, a medical physics resident at the UTHealth McGovern Medical School.

Dr. Mahesh: In January 2019, the American College of Radiology (ACR) Board of Chancellors approved the establishment of Richard L. Morin, PhD, Fellowship in Medical Physics, sponsored by the Commission on Medical Physics. The fellowship allows us to provide a medical physics resident-in-training an opportunity to learn about the inner workings of the college, and at the same time attract younger medical physicists to become members of the College and contribute to all of the important work we will be doing in the coming years as we continue moving into value- and population-based healthcare.

As this was the first time the fellowship was available, we weren’t sure what to expect. We received ten strong applications and the Commission had a difficult time selecting one fellow. After reviewing all of the applications closely, we unanimously selected Ashley E. Rubinstein, Ph.D. as the inaugural fellow.

Ashley RubinsteinDr. Rubinstein: I am extremely honored to have been chosen for the Fellowship. I first heard about this opportunity through Dr. Susan John, the Chair of Diagnostic and Interventional Imaging at the UTHealth McGovern Med School, who encouraged me to apply. During residency, I have become involved with global health initiatives through the IAEA and RAD-AID, where I have used ACR standards and guidelines as a framework for improving radiological care. I knew the Morin Fellowship would be a wonderful opportunity for me to learn more about the ACR and how I, as a physicist, can impact the field of radiology.

 Dr. Mahesh: Dr. Rubinstein, we are very excited to welcome you to the College’s annual meeting, ACR 2019, this May – and to have you spend a week at the ACR headquarters to learn about the inner workings of the College and also to complete a project as part of your fellowship.

We know that accredited medical physics residency programs do a great job training our incoming medical physicists like you, but we also realize that a lot of what the ACR does is somewhat of a black box to this group. This fellowship will provide an opportunity for you and other young medical physicists to not only learn, but also play a more active role in the key activities of the College in the coming years.

Dr. Rubinstein: Thank you, Dr. Mahesh. I look forwarding to gaining a better understanding of the context in which ACR standards have been established and the precise impact these standards have had on the field of radiology. I also look forward to promoting the principles of the ACR both in the United States and globally. Thank you so much for this opportunity.

  • Do you have questions about the new Morin Fellowship?
  • Do you have questions about radiation, image quality, the physics of medical imaging or the Commission on Medical Physics’ work? We’d love to answer them.

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IDEAS Study: Closing in on a Terrible Killer

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The IDEAS Study site map appears on the monitor behind Dr. Siegel

This post was contributed by Barry A. Siegel, MD, professor of radiology at Washington University School of Medicine, IDEAS Study co-investigator, and previously co-chair of the National Oncologic PET Registry (NOPR).

IDEAS Study results published this week in JAMA confirm that amyloid PET imaging serves a vital role in the management and diagnosis of the 5.5 million Americans suffering with Alzheimer’s – the nation’s sixth leading cause of death.

PET imaging used to detect Alzheimer’s-related plaques in the brain changed management of nearly two-thirds of patients with mild cognitive impairment and dementia – and diagnosis of the cause of these effects in nearly a third of such patients.

What’s more, the study results are generalizable across much of the US population as participating sites included community clinics, freestanding imaging centers and other non-academic settings – in addition to large teaching hospitals.

At present, there is no cure for Alzheimer’s disease – but research is actively ongoing on many fronts.

I am proud that the American College of Radiology managed this landmark trial and that radiologists are such a large part of this great effort.

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Working to Address Interoperability and Data-Sharing

Hirschorn David 2016-02-24This post was contributed by David S. Hirschorn, MD, who serves on the ACR Government Relations Commission-Federal Regulatory Committee and Informatics Commission

Policymakers continue to be interested in barriers and opportunities related to interoperability and heath information exchange. The American College of Radiology (ACR) Government Relations team has worked closely with ACR Informatics to help address these issues.

In 2013, the ACR Council passed a resolution (Res. 53) directing the College to explore legislative and regulatory mandates that would promote interoperability and exchange of patient data across disparate systems and providers.

Soon after the resolution, ACR successfully advocated for the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) to strengthen the interoperability requirements of the EHR exception/safe harbor from self-referral/anti-kickback prohibitions. The goal was to ensure that EHR technology donated at low cost to referring physicians could not be legally used to discourage referrals to competitors.

In 2015, ACR endorsed legislation to expand OIG’s authority to investigate and penalize anticompetitive “information blocking” practices by dominant providers and health IT vendors above and beyond the restrictions of self-referral and anti-kickback regulations. The language evolved into Section 4004 of the 21st Century Cures Act (Cures), which was signed into law in December 2016.

In March 2019, ACR provided feedback to the Networking and Information Technology Research and Development (NITRD) Program addressing high-level questions on medical device interoperability. The ACR discussed ways NITRD-participating agencies could collaborate with other actors to improve exchange between of FDA-regulated “medical devices” and EHR technology.

After an extended delay, CMS and ONC released proposed rules in March 2019 to implement, among other things, certain key aspects of the aforementioned information blocking provision mandated by Cures Section 4004. If implemented and enforced appropriately by HHS agencies, the information blocking provision could help reduce anticompetitive practices and other nontechnical barriers to data-sharing. Additionally, the proposed rules would expand the U.S. Core Data for Interoperability to include imaging narrative data, implement requirements for vendors and payers around API-enabled access to health information, and update the requirements of ONC’s health IT certification program. (CMS NPRM summary | ONC NPRM summaries)

The long-awaited CMS and ONC proposed rules, while encouraging, are not perfect. The ACR Government Relations Commission-Federal Regulatory Committee, Informatics Commission leaders, and individual volunteers are currently reviewing the details and providing input for ACR’s future comments.

  • We encourage members interested in providing feedback to contact Michael Peters, ACR Director of Legislative and Regulatory Affairs, at mpeters@acr.org within the next few weeks.
  • What barriers are you facing when it comes to interoperability and data sharing in your practice?

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