Finding Solutions at the ACR Annual Q&S + Informatics (Q&S+I) Conference

The ACR Annual Conference on Quality and Safety + Informatics left attendees feeling optimistic about the future as they found actionable solutions to challenges facing the specialty.

At the ACR Annual Quality and Safety + Informatics Conference (Q&S+I), held in San Diego in September, radiologists, radiology team members, quality improvement (QI) and informatics professionals were all about embracing challenges and finding practical solutions to common problems. The keynote “LI-RADS^® From Birth to Now: Lessons in Leadership,” taught attendees valuable lessons learned throughout LI-RADS’ almost 20-year history. Through this experience, Claude B. Sirlin, MD, showed how one radiologist could ultimately change the management of primary liver cancer by incorporating key feedback and not running from a problem — but rather engaging patients, clinicians and other colleagues to develop a solution. Sirlin highlighted the value in encouraging others to create their own vision, learn how to manage being an imposter and learn when to step aside.

Rising to the Challenge

Manjil Chatterji, MD, shared his leadership journey with attendees to spark discussion around how clinicians could shape the profession through individual efforts around quality.   In his session, “Improvement Science at Scale: Leadership Strategies Lessons from a Chief Quality Officer,” Chatterji reminded attendees “empathy translates metrics into meaning, fueling vulnerability and motivation.” Chatterji gave an example of a nurse checking a patient’s wristband for their name. That nurse is not only complying with regulations but also expressing empathy for a patient who is reassured by being seen as a person with a name. 

Other sessions described actionable ways attendees might mitigate some of the ongoing challenges within the healthcare landscape. In the session, “Findings that Matter: Separating Signal from Noise in Imaging,” Matthew Davenport, MD, MBA, appealed to attendees to protect patients from low-value care and voice concerns about whole-body MRI. In the same session, Jeffrey P. Guenette, MD, MPH, suggested that many recommendations for additional imaging contribute to lower-value care and unnecessary imaging.

Radiology workforce shortages and the impact on quality and safety were also a hot topic at the meeting. Nelly Tan, MD, Dave Facchini, MBA, BSRT, and ACR CEO Dana H. Smetherman, MD, MPH, MBA, FACR, gave perspectives from patients, radiologic technologists and physicians, respectively. The panel discussion following their lectures discussed whether to consider the use of radiologist assistants (RAs) to fill gaps in the workforce. The presenters acknowledged a definite need for additional staffing; there was discussion focused on concerns that these RAs may not provide the same level of care to which radiologists adhere. Smetherman recommended that radiologists step up to the challenge by developing more radiology residency positions and programs. Additionally, she encouraged attendees to engage young and emerging faculty in quality initiatives at the ACR and in their own practices and to encourage members-in-training to become young physician ACR members at higher rates to ensure we will continue to have leaders in radiology quality and safety in the future.

Embracing AI

Attendees participated in robust conversations about the use of AI in imaging. In Wednesday’s keynote, Ryan K. Lee, MD, MBA, encouraged attendees to embrace new technology and to seek solutions to the problems it presents rather than ignore it. “Don’t be Kodak,” Lee advised attendees, citing how the company refused to adapt to changes in digital photography and went bankrupt as a result. In a joint session on AI Governance, Shlomit A. Goldberg-Stein, MD, showed attendees how to build trust and adopt AI at scale by empowering those closest to the work and treating AI deployment not as a technical roll out, but as a negotiation to get to “yes.” Presenters in the session also discussed the principles, the data and the management of AI governance, recommending the best chance for success is obsessive attention to detail and process. 

The AI interoperability session saw presenters discuss common data elements for radiology observations and how they might be used to standardize AI output and enable transparency. “Pointing to the structure and standard will enable us to make the heterogeneity both meaningful and actionable,” said Marta E. Heilbrun, MD, MS, one of the conference’s chairs. Florence Doo, MD, MA, presented on human-AI interaction in her session, “Between Worlds: Radiologists Leading Human-AI Ecosystems.” She explained how radiologists needed to adopt new language to explain and leverage the potential of AI, as well as embrace radiology’s stewardship of the technology. 

Ultimately, the conference left attendees with optimism, noted by Goldberg-Stein and Gloria L. Hwang, MD, a conference chair. Although attendees discussed real and difficult challenges faced by the specialty, they also found actionable ways to combat them. “There’s a lot of work to do, but there’s a lot to be optimistic about,” noted Goldberg-Stein. Hwang added, “There’s a universal acknowledgment that we can’t do things the way we did before. [These challenges] can be scary, but they show us an opportunity — ways that the specialty can come together and decide what we want to fight for.”

By Meghan Edwards, freelance writer, ACR Bulletin