Aging adults are major consumers of diagnostic imaging services, and as the proportion of adults older than age 65 grows, imaging costs also could escalate. This increased utilization is problematic in cases where imaging provides little value. Consequently, researchers and policymakers are attempting to define these scenarios so they can develop and apply levers to curb inappropriate use. On the flip side, however, imaging services can provide critical information to inform treatment of diseases common among older adults and reduce downstream costs of managing these diseases.
Consider stroke. Annual stroke costs in the U.S. have climbed to $43 billion, and 16 percent of these costs derive from rehabilitation.
Conventionally, physicians have relied on a “golden window” of three to 4.5 hours to inform decision making about stroke treatment. This window, however, leaves some patients—those with an unknown time of onset or those who exceed the window but with viable tissue—untreated.
Advanced visualization may help shift the paradigm.
Preliminary results of the Stroke Treatment and Revascularization Therapy (START) trial presented July 24 at the Society of NeuroInterventional Surgery’s annual meeting in San Diego showed CT angiography (CTA) data could be used to predict which stroke patients could benefit from endovascular therapy. Physicians used imaging, rather than the arbitrary time window, to inform treatment. Nearly half of the patients in the trial saw a good clinical outcome.
In Japan, researchers have developed a platform to enable remote stroke consults via mobile phone-based software. The technology, called i-Stroke, transfers clinical and imaging information necessary to diagnose stroke, such as CT scans, MRI images and CTA, plotted on a three-hour timeline to help the remote physician visualize the patient's stroke progression against the clock. I-Stroke may bring stroke expertise to areas where it is lacking and thus expand the pool of patients eligible for treatment.
In both examples, imaging is helping to re-write the treatment model, improve patient care and contain downstream costs. Identifying such opportunities is vital to our healthcare system.
How is your organization tapping into advanced visualization to meet these key objectives? Please let us know.
Lisa Fratt, editor