Next week, when I walk into Chicago’s vast McCormick Place Convention Center—at 2.6 million square feet in size, spread out across four huge buildings, it is the largest convention center in North America, and one of the largest in the world, and certainly one of the busiest—it will be fascinating to see how RSNA24—this year’s version of the annual RSNA Conference, still the largest annual medical conference in the world—will have changed since RSNA23.
The RSNA Conference is sponsored at McCormick Place every year the week after Thanksgiving, by the Radiological Society of North America, the global association of professionals connected to the medical specialty of radiology, whether as radiologists, radiologic techs, clinic and hospital executives and managers, educators, or vendors. The Oak Brook, Ill.-based association was established in 1915—an astonishingly long time ago for that specialty—and has members representing 150 countries. And, as an aside, speaking as a multilingual, it is always a delight to hear people speaking dozens of languages in the exhibit halls and corridors every year at McCormick.
In any case, in the 30-plus years in which I’ve been attending the RSNA Conference, the conference has changed dramatically in nearly every way. Sure, every year there are hundreds of scientific sessions intended for radiologists and other clinicians and radiological support professionals. But the number of sessions connected to artificial intelligence has in the last few years exploded—there are many dozens offered this year—and in addition, there are numerous sessions dedicated to such issues as healthcare policy, health equity, and other non-clinical topics—something that simply did not exist in 1991, the first time I attended the conference.
Meanwhile, the exhibit floor has been completely transformed over the years. Twenty-five years ago, the exhibit floor landscape was a radiologist’s world, with radiology chiefs and practicing radiologists traipsing back and forth across the floor looking at the latest CTs, MRs, and PET-CTs, and eager salespeople hawking their modality wares. But already by 2000, a seismic shift had begun, as, A) virtually every hospital and large outpatient clinic had all the modalities it needed already, and the only real market was for replacement equipment or highly specialized machinery; and B) the PACS revolution was already well underway by 2000, with film being replaced by digital images, and a focus building quickly on the PACS (picture archiving and communications systems) and RIS (radiology information systems) systems needed to operate these complex digital empires. Not long after that came the VNA (vendor-neutral archive) wave, and a broader approach focused on the entire enterprise, whether it be a single facility or, increasingly, very large multi-hospital health systems—and the need to store and share not only radiological images, but also cardiological ones, and eventually dermatological, etc.—all through coordinated systems.
But the biggest wave that had been building for decades, really, was the one that is upon us now: the U.S. healthcare cost wave. As the actuaries at the Centers for Medicare & Medicaid Services (CMS) warned us in June, the total overall cost of the U.S. healthcare system is on track to explode from its current $4.8 trillion a year—an already-mindblowing sum—to a total estimated $7.7 trillion a year by 2032—a 60-percent increase in overall U.S. healthcare costs over the next eight years, driven by the aging of the population and an explosion in the incidence of chronic illness.
And of course, radiologists as a specialty are going to be in the center of this whirlwind, for several reasons. First, with the aging of the population, the demand for diagnostic imaging studies will be exploding. Second, the supply of practicing radiologists simply cannot keep up with that increase in demand, and radiologists, who are already stressed out, will be more so in the coming years. And third, radiologists are sitting in the bullseye of policy leaders’ and regulators’ sights, given the tremendous expense of diagnostic imaging overall.
Cue the emergence of artificial intelligence (AI) and machine learning (ML). AI/ML will be needed more than ever, simply first of all to help radiologists keep up with the ever-intensifying demand for volume production. And second, the reality is that radiologists are increasingly going to be relying on AI-driven technologies for help in prioritizing their study interpretation order, as well as, in some cases, help with diagnostics (though that is a complex discussion in itself).
In any case, the reality is that radiologists and radiology are going to have to adapt as are all medical specialists and specialties, going forward. And as a result, the RSNA Conference is going to continue to evolve forward as well. Already last year, the conference offered a record number of sessions touching in some way on AI; that number is inevitably going to be even larger this year.
Radiologists are smart, and they’re adaptable; and after all, they are the most technology-savvy and tech-friendly of all medical specialists. So it will be interesting to see what the Zeitgeist is like next week at RSNA24. The world is changing rapidly, and RSNA and radiologists and the radiology specialty inevitably are being caught up in all the change. It should be a fascinating week ahead.
