ACR Bulletin

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Changing With the Times

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As the COVID-19 pandemic ramped up, the ACR empowered members to care for patients during the global crisis — without losing focus on its pre-pandemic mission.

With strong leadership throughout the pandemic, the College has enhanced its recognition as an international leader. Thank you to all our volunteers and members as we look forward to better times in 2021.

—ACR BOC Chair Howard B. Fleishon, MD, MMM, FACR
December 28, 2020
“When my group first realized we were in a crisis with COVID-19 last spring, we had to act quickly to adjust our polices, staffing, and protocols to keep ourselves, our patients, and our community safe,” says Jennifer L. Kemp, MD, FACR, body imaging subspecialist and vice president of Diversified Radiology in Denver. “The ACR was with us every step of the way.”
 
The pandemic has been a stark wakeup call. Healthcare professionals were compelled to rethink daily operations and the safety of colleagues and patients overnight — searching for reliable information to help them battle an unprecedented threat. “As the head of operations for a 65-person private practice, I had to adapt to this new world without warning — communicating with multiple hospitals and outpatient imaging centers,” Kemp recalls. “I used the ACR’s resources for each challenge we came up against, and they were available to us immediately when the pandemic struck.”
 
“The ACR’s role as the voice of radiology — to payers, policymakers, and patients — has been critical in making sure radiologists are part of the national conversation on how to deal with COVID-19,” ACR President Geraldine B. McGinty, MD, MBA, FACR, says. “The pandemic may have been unpredictable, but that doesn’t prevent us from being in the best position possible when preparing our members for the future.” As the world moves through this crisis, the ACR continues to adapt to member needs with the resources spotlighted here, keeping patient-centered care at the heart of ACR’s core purpose — now and beyond the pandemic.

Sharing Knowledge Quickly

The College moved quickly to keep members informed during each stage of the pandemic, while also connecting practices throughout the country to share knowledge and disseminate lessons learned. A library of resources is available at acr.org/COVID19.

Charting a Return to Care

While everyone was reeling from the first and second waves of the pandemic, radiologists focused on getting out in front of the crisis and anticipating the needs of patients and their healthcare providers, ACR BOC Vice Chair Jacqueline A. Bello, MD, FACR, says. “Thinking ahead, we assembled a team to look at resuming routine care beyond the pandemic,” she says. “That culminated in recommendations that were published in the JACR® soon after the outbreak.”1

The authors of the JACR article represented a diverse group. “Age, gender, specialty and practice type, and geographical areas of the country were counted,” Bello says. “Contributors came from the areas hardest hit by COVID-19 — with the goal of sharing lessons learned during the crisis to address critical care and climb back toward vital routine screenings. The effort was emblematic of the ACR — member-driven, fair and balanced, and focused on urban and rural areas alike.” In the spirit of that fairness, ACR’s Quality and Safety (Q&S) arm has been working with facilities seeking accreditation by extending time needed to meet requirements and payments. Q&S has also shared resources from the FDA and the Society of Breast Imaging through its COVID-19 Resource Workgroup. 

“Our members needed to know that we were relying on science, synthesizing a rapidly evolving environment, and doing everything we could to ensure a safe environment for staff and patients,” says McGinty. “It was important that we spoke with a unified voice as a radiology community.” 

In tandem with the practice-focused guidance, the ACR released an infographic for a patient audience, explaining the safety measures radiology groups are taking (available at bit.ly/ReopeningSafe). “These types of infographics — in a one-page format that can be shared among radiologists, their staff, and patients — are a great way to ensure we get patients back safely,” says Arun Krishnaraj, MD, MPH, chair of the Commission on Patient- and Family-Centered Care. 

“I think most people still trust their physician and health system more than they trust politicians,” Krishnaraj says. “Radiology can play a lead role by letting people know the truth, not politicizing the virus.”  

Following Science

The ACR has been vocal in its support of CDC guidance on wearing masks and keeping distance from those residing outside of their own households to protect against COVID-19. The College’s position to date is that, as physician leaders, radiologists should set an example — helping the patient population understand the risks of transmission through clear and simple communication that is rooted in science.

CREATING A DATA RESOURCE CENTER

A silver lining to the challenges of the COVID-19 pandemic are radiology collaborations that have emerged in response to the crisis. Organizations taking on distinct roles for a singular purpose has resulted in valuable initiatives, such as the Medical Imaging and Data Resource Center. The open-source database contains thousands of COVID-19 images and helps physicians better understand, diagnose, and treat patients with this new disease. This is a multi-organization effort, created by the ACR, RSNA, and the American Association of Physicists in Medicine, hosted by the University of Chicago, and funded by the National Institute of Biomedical Imaging and Bioengineering. Learn more at bit.ly/MIDRC. 

Contributing to a New Imaging Registry 

The ACR Center for Research and Innovation™, along with the ACR Data Science Institute® and the Society of Thoracic Radiology, created the COVID-19 Imaging Research Registry (CIRR). The CIRR aggregates diagnostic imaging and clinical information, providing real-time integrated data that serves as a public health surveillance tool. 

Immediate uses for the CIRR data include education, AI algorithm development, and research studies. In addition, assembling this type of aggregated and easily accessible data can inform a long-term strategy for individual practices. On a longer-term scale, the ACR can also leverage the aggregated data from its registries to approach payers around reimbursement.

Participating sites will contribute demographic information, clinical data on signs and symptoms, imaging exams, and laboratory test data and outcomes. Complete the form at acr.org/COVID-Registry and a member of the ACR CRI team will follow up with you. 

Meeting Virtually

Just as the 2020 annual meeting went online to keep the business of the College moving forward, ACR 2021 will take place virtually in May. The College’s decision was made with the safety of members, their families, and staff in mind, says ACR Speaker Richard Duszak, Jr., MD, FACR. “With so many anticipated attendees still under travel restrictions, a virtual platform will engage more members in governance, knowledge-sharing, and networking activities,” Duszak says.

Targeting Advocacy

“The ACR is providing financial guidance on top of clinical guidance during the pandemic,” Samir B. Patel, MD, FACR, founder and director of the value management program at Radiology, Inc., in Mishawaka, Ind., says. “There are economic and regulatory updates you can access as an ACR member. This information alone is a significant immediate return on investment of membership.”

The ACR has been fighting reimbursement cuts set to take effect starting this month related to the upwards reevaluation of evaluation and management (E/M) code changes in the Medicare Physician Fee Schedule (MPFS). Changes to the MPFS mean radiologists and other providers face massive cuts, and jeopardize patient access to vital services. The College and other medical societies have supported legislation that — while including important pay increases for primary care physicians and others — would avert reimbursement cuts to other physician and non-physician providers. Throughout the pandemic, the ACR has maintained that financial stability for Medicare providers is critical as they strive to meet the continued needs of patients during COVID-19 and beyond. Learn more at acr.org/EM.

Supporting the Next Generation of Radiologists

Online learning has been an adjustment for the next generation of radiologists during the pandemic. With many radiology residents and medical students displaced from their clinical learning environments, traditional education has moved online. With virtual resources like Radiology-TEACHES® (an online resource hub that uses case vignettes integrated with the ACR Select® CDS tool), radiology students have been able to stay informed and engaged. Radiology-TEACHES covers everything from case studies to imaging protocols. A COVID-19 module was developed and made available across the nation, ensuring that students, residents, and radiologists have the most up-to-date information. 

Learning from Leaders 

The ACR-RBMA Practice Leaders Forum, taking place online Jan. 22–23, 2021, will explore radiology’s approach to the pandemic (register for the meeting at acr.org/PLF). Attendees will have an opportunity to exchange personal experiences with navigating COVID-19 and hear from a panel of experts on how to ensure patient safety — while adopting COVID-related practice management strategies that can strengthen business and performance. 

Sessions will also focus on supporting diverse teams during stressful times, whether that’s a global pandemic, a practice-level crisis, or a personal issue. “You have to look at the individual needs of your colleagues,” notes Bello, “because the best PPE can be the morale of the team.” 

Connecting with Colleagues

The COVID-19 pandemic is having a profound impact on radiology practices across the country. We Are ACR is available to you, your colleagues, your patients, and patient advocates to contribute uplifting stories and personal testimonials of how you’re battling the effects of the pandemic. These stories are meant to inspire you and exemplify just how important your work is. Please take a moment to submit your picture and written story, a soundbite or short video clip — share how COVID-19 has impacted your practice. Please write a short piece — 1,000 words or less — or record a brief video to share your thoughts and action items so that your ACR community can learn more about your work. Visit acr.org/WeAreACR to share your story.

Caring for Ourselves

Self-care is a critical part of well-being — but how do you make time for yourself in the middle of a pandemic? Visit acr.org/wellbeing to find a list of resources, activities, webinars, podcasts, and more to combat the toll of COVID-19. If you have a resource you’d like to share, please contact copllstaff@acr.org.

Screening for Lung Cancer 

Unfortunately, lung cancer doesn’t wait for COVID-19 — and a delay in care may result in negative outcomes, a delay in diagnosis, or increased cancer burden on hospitals. To resume screening at hospitals where it’s possible, the ACR LCS 2.0 Steering Committee has prepared a new toolkit at acr.org/lcs, containing vital information and template documents for both referring clinicians and patients.  

 

ENDNOTES

  1. Davenport MS, Bruno MA, Iyer RS, Johnson AM, Herrera R, Nicola GN, et al. ACR statement on safe resumption of routine radiology care during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Radiol. 2020;17(7):839–844.

Author Chad Hudnall,  senior writer, ACR Press