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Robert A. Cascella

The future of precision medicine

By Robert A. Cascella
From the July 2018 issue of DOTmed HealthCare Business News magazine

Every day, I see radiology departments, practices and clinicians challenged to do more with less. It is a formidable mission, but I believe such challenges – clinical, operational and financial – are positive forces driving us to view diagnosis and treatment as a complete ecosystem generating adaptive intelligence and ushering in the long-awaited era of precision medicine.

Understanding the challenge for radiology
Medical imaging technology has already revolutionized health care, allowing doctors to find disease earlier and improve outcomes – and thereby turn countless patients into survivors. With imaging at the hub of patient care, radiologists are serving more patients than any other specialty. The next generation of radiologists will see the global market for imaging increase at a compound annual growth rate of 5.1 percent between 2016 and 2021.
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Even as volumes are growing, with an approximate seven percent increase predicted over the next several years, imaging is under great pressure to improve access, outcomes, and cost of care. This is especially true in the U.S., where declining reimbursements and demands for value-based care have brought increased scrutiny over exam appropriateness. It’s no wonder nearly half of radiologists feel some form of burnout.

One reason for this is the need to process more data per clinical decision. From 1990 to 2020, there will be a more-than-100-fold increase in the information derived from a diagnostic imaging exam. Another is cost pressure, with unnecessary, suboptimal and repeat imaging procedures costing as much as $12B+ annually. In addition, radiology must increasingly include the perspectives and needs of multiple stakeholders: patients/caregivers, technologists, radiologists, collaborating physicians and administrators. Addressing these issues is crucial, but addressing them individually just isn’t enough. It’s time for a new paradigm.

Creating a diagnosis and treatment ecosystem
I believe radiology needs to become part of a complete diagnosis and treatment ecosystem that seamlessly integrates people, technology and data to derive a “collective genius” that is the foundation of precision medicine.

Such an ecosystem should include:
• Patient-centered solutions to reduce stress and discomfort.
• Intelligent solutions to support staff and reduce variability.
• Contextual insights to enhance productivity and diagnostic confidence.
• Methods for enhanced confidence in diagnosis and treatment planning.
• Sophisticated navigation and guidance for new treatment possibilities.
• Data-driven tools for confident practice management.

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