Randy C. Miles

A national county-level model that incorporates sociodemographic factors associated with mammography screening engagement could be used to estimate expected screening rates based on each county’s sociodemographic profile.

Using a radiology-centric community engagement model, radiologists can address health disparities by engaging with communities and using established frameworks to develop tailored programs that improve access to radiologic care.

Purpose Increasing CT capacity to keep pace with rising ED demand is critical. The conventional process has inherent drawbacks. We evaluated an off-console automated AI enhanced workflow which moves all final series creation off-console. We hypothesized the off-console workflow would 1) decrease overall ED CT exam begin to end times and decrease length and variability of time CT is occupied at the individual exam level. Methods Study population was identified retrospectively and included all CT exams done on all ED adult patients. 3 months of data was collected using the conventional workflow and 3 months of data was collected after implementation of the off-console workflow. Exam begin and the exam end timestamps were collected from the EMR. Additionally, 4 subgroups from the above conventional and off-console workflows were identified retrospectively with an Emergency Severity Index level 1, undergoing one of the four most common CT exam set(s) performed on ESI level 1 patients. Results 6,795 ED adult patients underwent ED CT in the 3 months immediately prior to implementation of the off-console workflow and 6,708 adult ED patients underwent CT in the 3 months after complete implementation. The off-console workflow demonstrated a 36% decrease in median exam begin to end times (P < 0.001). 4 subgroups demonstrated 56–75% decreases in median CT occupied time (P < 0.001) and decreases in variability in ¾ subgroups. Discussion This off-console workflow enables increased CT capacity to meet rising ED demand. Similar improvements could be expected across most exam sets and imaging settings if broadly implemented.

Opportunities exist to provide high-quality breast imaging fellowship training in the community setting. Various challenges exist, however, including obtaining funding for a fellowship position, creating an educational curriculum in a potentially nonacademic environment, and developing an overall competitive program that will attract radiology trainees. Here, we explore factors that contribute to the establishment of an academic breast imaging fellowship program in the community setting based on experience, including (1) providing guidance on how to secure funding for a breast imaging fellowship position; (2) developing a training curriculum based on established guidelines from the Accreditation Council for Graduate Medical Education, American College of Radiology, and Society of Breast Imaging; and (3) navigating the landscape of the recruitment process, from program branding to matching applicants.

Health services research (HSR) is a multidisciplinary field of inquiry that examines how health care is structured, providing valuable data on health care outcomes and delivery. Over the past few decades, a shift in the U.S. health care system toward value-based care has placed a priority on health services topics. Health services research has been central to the evolution of breast imaging over this period, with increased emphasis placed on the following: (1) design of appropriate-use criteria for imaging services; (2) determination of cost-effectiveness of imaging protocols and screening regimens guiding policy; and (3) evaluation of policy related to reimbursement for diagnostic imaging and image-guided procedures. Examples of HSR topics that can be applied directly to breast imaging include evaluation of health care availability and accessibility, analysis of health care use patterns, exploration of patient preferences, assessment of technological innovation, development and implementation of clinical practice guidelines and screening strategies, and examination of health care organization and delivery models. Breast imaging radiologists who perform HSR are uniquely positioned to advocate for patients, to promote transformative health care interventions, and to influence policy changes and public health initiatives in breast imaging through analysis of health care data and translation of their research findings. In this Training and Professional Development article, we aim to provide practical approaches to explore interest in HSR and to describe a framework for successful integration of HSR into a breast imaging career.