Radiology

Specializing in all the modalities of on-site and remote radiologic coverage, plus after-hours final reads, we deliver prompt, accurate preliminary and final reads interpretations.

Sheridan’s industry-leading quality management program ensures that our discrepancy rates are consistently well below the national average. Radiology turnaround routinely transcends contracted times and 24/7 coverage is available. Sheridan radiologists are always available for additional consultation.

The stability of our clinical staff is evidenced by a 95% retention rate. All physicians are fellowship-trained or board-certified, locally licensed and based in the United States. We follow NCQA certification for credentialing and conduct our own approved physician review process. Learn more about our radiology management services.

Read our radiology-related posts:

21 March2017

Three Breakthrough Technologies That Will Change Medicine

The Massachusetts Institute of Technology (MIT) publishes an annual list of 10 Breakthrough Technologies. Three innovations from this year’s list promise to have a dramatic impact on the future of medicine.

Brain Implants that Reverse the Effects of Paralysis

In recent years, brain implants have enabled lab animals and even a few people to use thoughts to control computer cursors or robotic arms. According to the 2017 MIT report,  researchers are “taking a significant next step toward reversing paralysis once and for all” using what French neuroscientist Grégoire Courtine calls a “neural bypass.” Wireless implants transmit electrical impulses from brain to spinal cord, bypassing damaged parts of the central nervous system and enabling movement of limbs once paralyzed due to spinal cord injuries. Courtine and a team of researchers at a Swiss university have used the implanted electronics to restore mobility of a partially paralyzed macaque monkey in hopes of future applications with humans.

A team at Cleveland’s Case Western Reserve University placed two of the same type of implants used in the Swiss experiment in the brain of a middle-aged quadriplegic volunteer who, on his own, could not move any part of his body other than his head and a shoulder. The implants are smaller than a postage stamp and “bristle with a hundred hair-size metal probes that can ‘listen’ as neurons fire off commands.” The Case team also inserted more than 16 fine electrodes into the muscles of the volunteer’s arm and hand. According to the MIT report, in videos of the experiment, “the volunteer can be seen slowly raising his arm with the help of a spring-loaded arm rest, and willing his hand to open and close. He even raises a cup with a straw to his lips.” This transformational technology is expected to be available in 10 to 15 years.

Next-generation Gene Therapy

For decades, researchers have been pursuing the idea of gene therapy—what the MIT report calls the use of “an engineered virus to deliver healthy copies of a gene into patients with defective versions”—with mostly disappointing results. Now, researchers have solved some of the puzzles that caused many earlier gene therapies to fail. Scientists are “using viruses that are more efficient at transporting new genetic material into cells” to develop the next generation of gene therapies—or “gene therapy 2.0”—to treat patients with rare hereditary diseases. 

European regulators have approved two of the treatments. One is Strimvelis, for treating children with severe combined immunodeficiency due to adenosine deaminase deficiency (ADA-SCID). The other is Glybera, for treating patients with lipoprotein lipase deficiency (LPLD), a rare disease that causes fat to accumulate in the blood and increases the risk of acute and recurrent pancreatitis. 

In the United States, one of Spark Therapeutics’ gene therapies for inherited retinal diseases (IRDs) is in phase III clinical trials. The company’s hemophilia B therapy, SPK-9001, is currently in an ongoing phase i/ii clinical trial and recently received breakthrough therapy and orphan product designations from the U.S. Food and Drug Administration. Another promising gene therapy in development could lead to a cure for hemophilia and enhance healing in patients suffering from epidermolysis bullosa, an excruciatingly painful and sometimes fatal hereditary skin disease. 

According to the MIT report, researchers are conducting clinical trials for gene therapies for some 40 to 50 diseases. “Fixing rare diseases, impressive in its own right, could be just the start.” 

The Human Cell Atlas

An international consortium of scientists is being assembled to develop the first comprehensive map of human cells. Biologists, clinicians, technologists, physicists, computational scientists, software engineers and mathematicians from the U.S., U.K., Sweden, Israel, the Netherlands, and Japan will be collaborating on the construction of what the MIT report calls “biology’s next mega-project”—a “cell atlas” that catalogs and maps the 37.2 trillion cells of the human body. 

The Human Cell Atlas website explains the significance of this massive, ambitious and unprecedented undertaking. “A complete Human Cell Atlas would give us a unique ID card for each cell type, a three-dimensional map of how cell types work together to form tissues, knowledge of how all body systems are connected, and insights into how changes in the map underlie health and disease. It would allow us to identify which genes associated with disease are active in our bodies and where, and analyze the regulatory mechanisms that govern the production of different cell types.”

The MIT report calls the future genomic reference map “a technological marvel that should comprehensively reveal, for the first time, what human bodies are actually made of and provide scientists a sophisticated new model of biology that could speed the search for drugs.”

According to the report, this new type of mapping is possible thanks to the confluence of three technologies: 

  • Drop-Seq—described in the abstract of a 2015 Cell article by Evan Z. Macosko and his colleagues as “a strategy for quickly profiling thousands of individual cells by separating them into nanoliter-sized aqueous droplets, associating a different barcode with each cell’s RNAs, and sequencing them all together.” 

  • Ultra-fast, extremely efficient sequencing machines that can decode and identify the genes active in single cells “at a cost of just a few cents per cell. One scientist can now process 10,000 cells in a single day.”

  • Innovative labeling and staining techniques that “can locate each type of cell—on the basis of its gene activity—at a specific zip code in a human organ or tissue.”

Among the key supporters of this project are the U.K.’s Wellcome Trust Sanger Institute, the Broad Institute of MIT and Harvard in Massachusetts, and the new Chan Zuckerberg Biohub in California funded by Facebook CEO Mark Zuckerberg and his wife, Priscilla Chan. Zuckerberg and Chan made the Human Cell Atlas project “the inaugural target of a $3 billion donation to medical research,” according to the MIT report. The human cell atlas should be available in five years.

16 March2017

New FDA-Approved Drug Proven Effective in Reducing Recurrent C. diff Infections

Among the healthcare associated infections that may arise during a patient’s hospitalization, Clostridium difficile is an especially dangerous ailment due to its easy dissemination and antibiotic resistance. Transmission may occur if medical staff touch surfaces contaminated with feces during and between treatment of patients. The few available antibiotics that can be used to treat the initial infection do not prevent its recurrence in about 20 percent of those affected. To improve the efficacy of current standard-of-care antibiotic treatments, the healthcare community has long sought after an antibiotic that will further reduce the rate of C. diff infection recurrence. According to a study published in the January 2017 New England Journal of Medicine, researchers seem to have found an antibiotic capable of treating recurrent C. diff.

In two extensive, double-blind trials conducted between 2011 and 2015, researchers tested the effects of actoxumab and bezlotoxumab on 2,655 patients receiving standard-of-care antibiotic treatments for their C. diff infections. Actoxumab and bezlotoxumab are human monoclonal antibodies designed to bind to and neutralize C. diff toxins A and B, respectively, thereby preventing infection recurrence. In separate studies known as MODIFY I and MODIFY II, patients were given antibiotic treatments that fell into four test groups: actoxumab-only, bezlotoxumab-only, both actoxumab and bezlotoxumab and a placebo.

At the end of each 12-week study, researchers found that C. diff infection recurred significantly less frequently in patients who received bezlotoxumab alone or both actoxumab and bezlotoxumab when compared with the placebo. In MODIFY I, the rate of recurrence was 17 percent under bezlotoxumab alone and 16 percent under the combined treatment, while recurrence under placebo was 26 percent. MODIFY II showed nearly identical results with 16 percent recurrence under bezlotoxumab, 15 percent under both antibiotics and 26 percent under placebo. 

To confirm that bezlotoxumab was the cause of reduction in infection recurrence, during MODIFY I, researchers compared results of the actoxumab-only group and the placebo group. Patients in these groups demonstrated similarly high recurrence rates of 26 percent and 28 percent. When researchers supplemented patients’ antibiotic treatments with actoxumab, they found high rates of adverse effects such as diarrhea and nausea following frequent C. diff infections. Adverse effects occurred at 67 percent under actoxumab alone, 61 percent under bezlotoxumab alone, 58.6 percent under combined actoxumab and bezlotoxumab and 61.2 percent under placebo. 

Overall, researchers concluded that bezlotoxumab accounted for a significant 38 percent reduction in C. diff infection recurrence when combined with standard-of-care therapy. As a result of MODIFY I and MODIFY II, the U.S. Food and Drug Administration recently approved the use of bezlotoxumab for C. diff infection treatments. While further research is warranted, the findings are a promising development toward the potential eradication of this costly and debilitating healthcare concern.

14 March2017

Newly ID’d Genomic Features of Cervical Cancer May Allow Targeted Therapies

Once known as the leading cause of cancer deaths for women in the United States, cervical cancer has been on the decline due to advances in detection technology and medical treatments over the last four decades. The latest example of this trend is a recent study by investigators with The Cancer Genome Atlas (TCGA) Research Network, which has identified novel genomic and molecular characteristics of cervical cancer that may aid in the creation of more targeted, effective drug therapies.

Through an analysis of the genomes of 178 primary cervical cancers, TCGA researchers found that more than 70 percent of cervical tumors had genomic alterations in one or both of two important cell signaling pathway. Further, researchers identified a unique set of eight cervical cancer tumors that demonstrated molecular similarities with endometrial cancers and had high frequencies of mutations in the KRAS, ARID1A and PTEN genes. Researchers unexpectedly discovered that all the tumors with genomic alterations and most of the endometrial-like tumors did not show evidence of human papillomavirus (HPV) infection, the leading cause of nearly all cervical cancer incidents.

The discovery of HPV-negative tumors with endometrial characteristics is significant in the pursuit of effective cervical cancer treatments. While current preventive vaccines are effective against the most oncogenic forms of HPV, most women who will develop cervical cancer are older than the recommended age for vaccination and will not be protected. The TCGA findings confirm that a notable portion of cervical cancers are formed from other factors not related to HPV. This signals the need for new cervical cancer treatments that specifically target genomic alterations and are effective for women regardless of age.  

TCGA researchers have already begun looking at the potential applications of the research for cervical cancer treatment. During the same study, researchers examined the tumors with genomic alterations to discover whether any alterations were particularly amplified. Amplification can predict genetic responsiveness to immunotherapy, a treatment which is becoming an increasingly important component of general cancer treatments. Ultimately, several of the alterations were amplified enough to be considered effective potential immunotherapy agents, including some alterations involving the gene BCAR4, which has been shown to respond to certain breast cancer immunotherapies

21 February2017

Research Recommends Continued Breast Cancer Screening Mammography for Older Women

New research about the appropriate age limit for breast cancer mammography screenings, presented at the Radiological Society of North America’s annual meeting late last year, challenges current conventional recommendations. While the U.S. Preventive Services Task Force (USPSTF) recommends that women undergo screenings every two years until age 74, researchers from the University of California at San Francisco assert this age limit may be arbitrary after finding that the precision of breast cancer mammography screening, and thus the rate of cancer detection, increases significantly as women age.

Pulling from the American College of Radiology National Mammography Database, the research team examined 5.7 million mammography screenings from 2.6 million women 40 years or older. The team found the average national cancer detection rate to be 3.74 per 1000 screenings, while the average recall rate of screenings leading to a call-back for additional workup was 10 percent. Further, the rate of cancers found in cases recommended for biopsy was 20 percent, and the rate of cancers found in women who underwent biopsy was 29 percent.

Next, researchers stratified the data into five-year age groups to identify any trends. They found that the recall rate decreased progressively every decade and that detection rates increased progressively with age. The team concluded that doctors should continue to recommend mammography screenings for women 75 years and older if it is medically appropriate based on preexisting conditions and life expectancy.

This conclusion coincides with growing evidence of high breast cancer incidents in older women. A similar study published in the May 2015 edition of the American Journal of Roentgenology found a significant detection of carcinomic and invasive breast cancer tumors in women 75 years and older at a rate of 5.9 per 1000 screenings. While detection rates for older women seem to have recently decreased, as the American Cancer Society states in its 2015-2016 report, almost 58 percent of all breast cancer deaths occur in women older than 65. Within this same group, women 80 years or older make up 46 percent of all deaths. 
 
Ultimately, at a time when the medical community is questioning the effectiveness of screening mammography, research still supports the necessity of continued, quality preemptive care for all – and especially older – women.

19 January2017

Integrating Telemedicine Responsibly

Providers and patients alike view telemedicine as an increasingly important healthcare delivery modality. Per a recent article in Medical Economics, “How to balance telemedicine advances with ethics,” the American Telemedicine Association (ATA) reports that more than half of all U.S. hospitals use some form of telemedicine; and IHS Technology predicts the number of patients using telehealth services will jump from fewer than 350,000 in 2013 to 7 million in 2018.

But this modality can also be challenging to implement responsibly.

Telehealth Benefits

The dramatic growth of telemedicine is driven by its ability to further the goals of the “quadruple aim” framework for value-based care.

More Efficient Care

The recent American Hospital Association (AHA) issue brief on telehealth cited several examples of significant telehealth-driven savings, including the Veterans Health Administration’s “nearly $1 billion in system-wide savings associated with the use of telehealth in 2012.” A major contributor was the dramatic decrease in hospitalizations.

In addition, doctors who offer telehealth services can spend more time caring for additional patients – time that otherwise would have been spent traveling between offices or facilities.

Better Outcomes

The AHA brief also describes the efficiencies and improved outcomes resulting from the innovative Hospital at Home (HaH) care model developed by Johns Hopkins researchers. HaH is being used effectively to provide hospital-level care at home in place of acute hospital care for older adults. Per the brief, “When a patient is treated at home, clinical staff travel to the home as needed to provide treatment, while telehealth is used to monitor the patient’s condition and enable daily meetings with the physician.” According to the program’s website, HaH patients experience better clinical outcomes, higher patient and family satisfaction, reduced caregiver stress and better functional outcomes compared to similar hospitalized patients.

Expanded Access to Care

Traveling to medical facilities can be a hardship for people who are physically challenged/housebound, live far from the nearest medical center or cannot afford to take time off from work. The ability to meet with a clinician remotely via a secure audiovisual device or application can mean the difference between those patients seeking – and getting – the care they need versus going without.

More Convenient Care

While it’s early days yet, “virtual visits” are beginning to be offered for more and more types of medical care. For example, St. Vincent Heart Center in Indianapolis is piloting a telecardiology program, per a recent article in Cardiovascular Business.

There is also increasing demand by health care consumers for “at home” virtual visits. A recent ATA-WEGO Health survey of active health care users found that consumers are very interested in using telehealth to complement (or even replace) their in-person care, primarily because of convenience. Other commonly cited reasons included scheduling conflicts and issues with transportation. 

Expanded Access to Specialized Clinical Expertise

Many small or rural hospitals often don’t have the budget or volume to support staffing a range of staff specialists or subspecialists. Even hospitals that have the budget may be in areas that make it difficult to recruit those types of physicians.

Dr. Lynn Palmeri, National Medical Director of Telehealth for Sheridan’s Women’s and Children’s Division, explains that telehealth carts can allow doctors at these facilities to consult remotely with specialists or subspecialists as needed. For example, an obstetrician may see an expectant mother with high-risk findings that require her to be referred out to see a perinatologist. Rather than having the mother drive three or four hours to the nearest perinatologist – potentially putting her and her baby at even greater risk – the obstetrician could have a remote telehealth consult with the subspecialist to determine whether the mother can be given appropriate care locally with the help of follow-up telehealth consults with the perinatologist.

Telemedicine is equally valuable in emergency medicine. Physicians in the adult emergency department (ED) at Jupiter Medical Center consult remotely with neurologists at the Cleveland Clinic using a telehealth cart approximately 10–30 times per month, most often to expedite implementation of tissue plasminogen activator (tPA) therapy for stroke patients.

Sophisticated telemedicine robots can allow remote specialists and subspecialists to perform much more in-depth examinations. Dr. Palmeri says “there are robots with sensors that can, for example, allow a neonatologist to remotely inspect a patient, auscultate bowel, breath and heart sounds, examine a neonate’s eyes for retinal findings, and even palpate to see if there is abdominal pathology or edema. These patient care modalities augment the in-person physical examinations by the nurse and neonatal nurse practitioner at the bedside.”

Radiology’s many subspecialties make it a prime candidate for expanding access to highly specialized clinical expertise remotely while also increasing efficiency. For example, Sheridan’s distributed teleradiology network includes hundreds of the country’s best radiology subspecialists who can provide hospitals of any size with affordable, 24/7/365 coverage and faster turnaround times for final reads. 

Challenges to Responsible Implementation

The promise of telemedicine is exciting, and pertinent logistical and quality matters will be ensured prior to its implementation and expansion.

Protecting Patient Privacy

Maintaining patient confidentiality is a cornerstone of ethical medical practice. Telemedicine systems will be HIPAA-compliant and hospitals must make data security a top criterion when selecting robot cart and software options.

Maintaining Care Quality

The same standards of care must be maintained regardless of the delivery modality, and that’s a key challenge of telemedicine. The American Medical Association (AMA) released its Guidance for Ethical Practice in Telemedicine in June. In the policy announcement, AMA Board Member Jack Resneck, M.D. said, "Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions. The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians' fundamental ethical responsibilities do not change.” The AMA also released its Principles to Promote Safe, Effective mHealth Applications in November. 

Telemedicine can make continuity of care challenging, especially when patients seek care from doctors who are not affiliated with their primary care physicians or who use different EHRs. But in some situations telehealth can improve care continuity. “In a pediatric unit, for example, an attending physician might see the baby during morning rounds, but by the time the parents can come to the hospital that evening after work that physician’s shift may have ended and the parents may not speak directly to that same doctor,” explains Dr. Palmeri. “Telemedicine has the potential to overcome those types of scheduling conflicts so that parents can speak with the doctor ‘face-to-face’ through the telemedicine robot screen whenever needed.”

Telehealth will play an increasingly important role in care delivery and physicians will carefully adopt remote care technology in a manner that ensures patient safety and privacy.

5 January2017

Our 10 Most Popular Blog Posts of 2016

The most-read posts on the Sheridan blog in 2016 focused on key topics – ranging from the challenges involved in the transition to value-based care and this country’s physician burnout epidemic to exciting technology innovations and trends in clinical practice.

The 10 most popular posts from the past year are:

  1. How to Manage the Burdens of Change on Physicians and Health Care Practitioners, a summary of Chief Quality Officer Dr. Gerald Maccioli’s presentation at the 2016 Health:Further Summit about the overwhelming burdens on providers created by current and planned changes to the U.S. health care landscape and strategies for managing them.

  2. Sheridan’s 2016 Leadership Conference Recognizes Eight Outstanding Clinical Leaders: Dr. Mike Adkins, Anesthesia Services Chief of the Year; Dr. Joseph Toscano, Emergency Medicine Chief of the Year; Dr. Frank Seidelmann, Radiology Chief of the Year; Dr. Mitchell Stern, Women’s and Children’s Chief of the Year; Dr. Adam Blomberg, Diamond Award Winner; Cindy Houck, CRNA, Platinum Award Winner; Dr. Gary Gomez, Innovation Award Winner; and Dr. Jonathan Katz, Innovation Award Winner.

  3. Six Physician Communication Strategies to Increase Patient Engagement and Improve Outcomes, including encouraging patients to talk about psychosocial factors that might be related to their conditions, tailoring communications to each patient based on his/her culture, values and beliefs to avoid inadvertent offense or mistrust, educating patients on care best practices and about responsible antibiotic stewardship, providing compassionate, personalized care and reassurance, and providing online information resources to educate patients and set appropriate expectations.

  4. Technology Innovations That Will Transform the Future of Radiology, including the groundbreaking work of the IBM Watson Health medical imaging collaborative, in which Sheridan and its chief of teleradiology, Dr. Glenn Kaplan, are playing a key role.

  5. Five Medical Practices That Soon May Be Outdated, including hospitals advising doctors not to apologize, prescription labels that don’t include what condition the drug is treating, monitoring handwashing by hospital staff, doctors spending more time on paperwork than on patient care, and making it difficult for patients to get their medical records quickly.

  6. The AMA’s New Tools to Ease MACRA Transition for Physicians, including the MACRA Assessment (aka Payment Model Evaluator), new MACRA-focused modules in the AMA STEPS Forward interactive, online practice transformation series, and the Inside Medicare’s New Payment System ReachMD podcast series.

  7. The Physician Burnout Epidemic, Part 1: Root Causes of This Alarming Trend, which looked at the factors fueling the increase in U.S. physician burnout. Part 2 offered strategies physician leaders can use to help combat burnout.

  8. Career Advice from Sheridan’s Chief Medical Officer for Radiology Services, Dr. Frank Seidelmann, including being proactive in managing your career, embracing technology and investing in your professional development and of the physicians you lead. 

  9. How Video Laryngoscopy Is Shaping the Future of Anesthesiology, which highlighted a discussion by Regional Medical Director Dr. Joseph Loskove, Chief Quality Officer Dr. Gerald Maccioli and National Education Director, Anesthesiology Division, Dr. Adam Blomberg in their Anesthesia News article, The Shift Toward Video Laryngoscopy: The Good, the Bad, and the Future.

  10. Pain Management Boosts Patient Satisfaction, which addressed the significant impact of addressing patients’ and caregivers’ concerns and setting their expectations appropriately – as well as treating patients’ physical pain – on their satisfaction with their pain management and overall care. 

19 December2016

Identify Pain Points First to Effectively Implement Radiology Process Improvements

Radiology departments are under tremendous pressure to increase efficiency without sacrificing quality, as nearly every department in the hospital depends on them to produce and read images in a timely manner. Hospital workflows are complex, and investments in new software, equipment or people that are not informed by a thorough understanding of the underlying causes of inefficiencies are unlikely to deliver the desired improvements.

An article in Radiology Today earlier this year advised department heads to do a full assessment of workflow processes to identify the “pain points” that result in inefficiencies. Pain points can be areas that may need improvement, like patient throughput, or areas where variability is introduced to the workflow. Dr. Paul Chang, vice chairman of Radiology at the University of Chicago School of Medicine, said software can often eliminate variability, particularly in workflow management. In situations that require judgment of complex results, it is best to identify strategies to facilitate the radiologists’ reading and decision-making. Solutions introduced into a workflow should address a specific existing problem, particularly given the high cost of investments in new software, equipment or staff.

In radiology, pain points are often procedural, rather than technical. Inefficient protocols that impede patient flow like ineffective patient transport or MRI triage processes can hugely impact the entire hospital by slowing radiology. An American College of Radiology case study detailed the effort to improve MRI patient throughput at Howard County General Hospital in Columbia, Maryland. Patricia Rabette, the hospital’s CT/MRI Manager, led an MRI quality improvement project that aligned everyone involved in imaging processes to eliminate pain points. Rabette scheduled regular meetings with a team including medical-surgical nurses and managers, patient care technologists, the unit secretary, the med-surg directors, MRI technologists, and a transport dispatcher to discuss inefficiencies and solutions. By unifying all the stakeholders into a single team to collaborate on solving the problems and emphasizing open-minded consideration of all ideas, the hospital was able to decrease MRI throughput times by three hours and increase patient satisfaction by 60 percent.

Using cross-functional teams to solve problems collaboratively is also at the center of Sheridan’s approach to continuous process improvement. For example, at one South Florida radiology department, a Sheridan Kaizen facilitator helped a team that included the registration desk, lab, physicians and nurses to closely examine and improve the department’s workflow. Based on the team’s recommendations, a change was made so that instead of requiring outpatients to wait in bed alone for one to two hours while lab results were pending, patients could remain in the waiting room while they awaited their lab results. This simple change decreased radiology wait times by 40 minutes.

Jupiter Medical Center’s Chief of Radiology Dr. Lee Fox, and CEO John Couris discuss how the Sheridan partnership and Kaizen-facilitated process improvements have been transforming radiology at the hospital.

8 December2016

McLaren Hospital’s CEO Discusses the Value of Sheridan’s Distributed Radiology Services

When William “Bill” Lawrence became CEO of McLaren Central Michigan Hospital eight years ago, he saw no significant clinical issues with the three-physician radiology group at the 118-bed acute-care hospital, per a new article in Radiology Today. He did, however, find problems typical of a hospital that size: slow turnaround times, lack of consistency and significant gaps in the radiology services and modalities offered. Lawrence turned to an old friend, radiology leader Frank Seidelmann, D.O., to ask for his thoughts on solutions that could improve McLaren’s radiology services at a reasonable cost. 

Both men had worked at the renowned Cleveland Clinic and had known each other for many years. Dr. Seidelmann suggested the distributed radiology services from Radisphere, a company he had co-founded with a colleague. Lawrence was extremely impressed with the solution, which could provide his three on-site radiologists with 24/7 remote access to Radisphere’s large network of highly respected radiology subspecialists from around the country, all of whom agreed to accept accountability for the quality of their work.

Lawrence, who naturally assumed this sophisticated solution would come with a hefty price tag, was surprised to learn about Radisphere’s fee-for-service business model. Dr. Seidelmann also explained that his company was willing to assume most of the set-up costs and build the data interfaces. That clinched the deal, and McLaren signed on soon thereafter.

Eight years later, Lawrence continues to be impressed with the quality improvements at McLaren since contracting with Radisphere, including “stellar” turnaround times and very low error rates, which are consistently less than five percent overall and less than one percent for errors that would have made a difference in diagnosis.

Following its acquisition last year by Sheridan, Radisphere has evolved into Sheridan’s Distributed Radiology Services (DRS), which uses teleradiology technology to give partner hospitals of any size access to more than 400 highly specialized radiologists nationwide. Dr. Seidelmann is now Chief Medical Officer and National Medical Director for Sheridan’s Radiology Services. 

To learn more about how our distributed radiology services have improved both the quality and efficiency of McLaren’s radiology offerings, read the Radiology Today article “Enhancing Workflow with Distributed Radiology Services.”

29 November2016

Three Radiology Research Projects to Better Understand Concussions

A recent article in Radiology Today illustrates how radiological imaging is becoming an increasingly important tool in studying and diagnosing concussions.

The Centers for Disease Control and Prevention estimate that 248,000 children and teens visit the emergency department each year to evaluate concussions suffered during physical activity. Concussions, also known as mild traumatic brain injuries, have serious short- and long- term effects on thinking, sensation, language and emotion. In the short run, repeated concussions can potentially cause dramatic, fatal brain swelling. In the long run, they have increasingly been linked to Chronic Traumatic Encephalopathy (CTE), Alzheimer’s, Parkinson’s disease and other brain disorders.

Public awareness of the alarming short- and long-term effects of concussions is growing quickly, but timely diagnosis remains difficult. Most diagnostic methods for concussions – particularly on athletic fields – are dependent on evaluation of symptoms that are often understated by athletes. Although radiological imaging is not yet a practical sideline solution, researchers have used it to better understand the physiological effects of concussions and track the brain’s recovery. The September 2016 issue of Radiology Today presented three current projects demonstrating how researchers are using imaging to better diagnose concussions, understand their severity and determine how they impact athletes’ brains. 

  • MRI Blood Flow Examination – Researchers at the Medical College of Wisconsin presented a study at the American Academy of Neurology’s Sports Concussion Conference in July on cerebral blood flow in football players. The study found that while concussed players’ symptoms would often improve to baseline levels by the eighth day following the injury, MRIs indicated ongoing low blood flow after the same amount of time. Decreased blood flow is often used as an indicator of cerebral microbleeds. Microbleeds are most commonly found in people over 60, and should not be present in high school students. Youth athletes demonstrating signs of microbleeds could potentially be at risk for CTE, which is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression and progressive dementia, according to Boston University’s CTE Center.  
  • Combining TechniquesResearchers at the University of Texas Southwestern Medical Center, Wake Forest School of Medicine and Children’s National Medical Center published a study in the May Journal of Neurotrauma finding that a single season of football can result in brain changes. The techniques they used include:
  1. Equipping helmets with sensors that detect impacts players received.
  2. MRI diffusion kurtosis imaging that detects both normal development and pathological changes in the white matter that allows the brain to make proper neurological connections.
  3. PET scans to detect tau proteins that are believed to cause cognitive impairment in Alzheimer’s patients.

The researchers are next looking to conduct longitudinal studies to observe long-term brain development. They are also planning to study non-helmeted athletes through alternative techniques such as equipping mouth guards with sensors.

  • Ultrasound Examination – In May, the American Association of Neurology presented a study that used ultrasound to map changes in blood flow after an injury. Although traditional ultrasound could only differentiate between concussed and control groups 60 percent of the time, the advanced software improved diagnostic accuracy to 83 percent. 

How Sheridan Healthcare, Jupiter Medical Center and Joe Namath Developed a Groundbreaking Treatment Protocol for Traumatic Brain Injuries

In 2014, Sheridan began a partnership with Jupiter Medical Center and legendary Jets quarterback Joe Namath to study the effectiveness of hyperbaric oxygen therapy to treat traumatic brain injuries. The FDA-approved clinical trial led by co-directors of the Joe Namath Neurological Research Center, Barry Miskin, MD, FACS and Sheridan Healthcare Radiology Medical Director Lee A. Fox, MD, MA, investigates how breathing pure oxygen in a pressurized chamber can stimulate the growth of new blood vessels to help the brain recover. After seeing improvements in Namath’s cognition and memory as a result of his continued hyperbaric oxygen therapy, the team hopes the study will provide valuable insights into how to combat the degenerating effects of concussions. While research and development of treatment options for concussions are in their early stages, the future applications could literally be game-changing.

For more information, see our blog post on hyperbaric oxygen therapy research.

17 November2016

Career Advice from Sheridan’s Chief Medical Officer for Radiology Services

One of the best ways to achieve success is to emulate and seek advice from someone who already has achieved that success. Frank Seidelmann, DO, one of this country’s foremost radiology experts, serves as an excellent role model for anyone looking to become a successful leader in radiology. Dr. Seidelmann is Chief Medical Officer and National Medical Director for Sheridan’s Radiology Services, the largest hospital-based radiology practice in the United States and the only unified, national standards-based radiology service provider. He recently was honored with Sheridan’s 2016 Leadership Award. 

In a recent article in Radiology Life, Dr. Seidelmann shared his path to the top of his profession and offered career advice on attaining a radiology leadership position.

Be Proactive in Managing Your Career

He advises those who aspire to follow in his footsteps to be proactive and forward-thinking in managing their careers. Thriving in a field that is constantly changing and facing widespread, fundamental disruption requires “developing expertise in areas that interest you and that you believe will be important.”

Dr. Seidelmann started down that path during his 1972-1976 residency at the Cleveland Clinic, where he was the chief resident in radiology and president of the house staff. Cleveland Clinic owned one of the first head CT scanners and the first whole body CT scanner and he was one of the first radiologists to work with cross-sectional imaging. Early in his career he chose to practice and develop expertise in several of the first radiology subspecialties that evolved from these new imaging technologies, before eventually narrowing his focus to MRI imaging interpretations.  

Embrace Technology

Dr. Seidelmann urges would-be radiology leaders to constantly stay abreast of emerging trends and technologies and to look for opportunities to solve problems with creative, technology-enabled solutions – something he has done throughout his career.

Dr. Seidelmann had co-founded what became a large, multi-state, multi-hospital radiology group with its own MRI imaging center. Seeing an opportunity when that practice was sold, he co-founded a software company whose product helps imaging centers understand their referral patterns, volumes and trends.

He was a pioneer in distributed teleradiology. In 2001, two years after launching his first teleradiology practice, he and a colleague merged their practices to bring to life their visionary concept: finding the best subspecialty radiologists in the country and connecting them in a distributed practice with teleradiology services. The new practice grew rapidly and in 2007 became a full-service radiology group, Radisphere National Radiology. Dr. Seidelmann also designed a QA process that was embedded into the company’s enterprise software system to enable real-time, daily QA assessment of cases. The software, analytics and business processes were so valuable that they eventually were split off from the professional services and launched as an independent software company. Sheridan acquired Radisphere last year.

Invest in Your Own Development and That of the Physicians You Lead

Dr. Seidelmann also advises those pursuing a leadership role in radiology to invest time and effort not only into the development of the physicians under their leadership but also into their own professional development. Despite his lifetime certification, Dr. Seidelmann has recertified multiple times over the course of his career to maintain and expand his skills and expertise.

Learn much more about his remarkable career and helpful career advice in his Radiology Life article, “How-To Guide: Becoming the Chief Medical Officer of a Radiology Practice.”

← Read More Radiology Posts