Integrating AI and Technology

Sadie Wangler is a seasoned healthcare professional specializing in diagnostic imaging and neuroscience program management. For the past five years, she has been the director of Diagnostic Imaging at Tahoe Forest Health System. Before this, she managed a Comprehensive Stroke Program at Renown Health. Wangler’s extensive experience includes her Imaging Specialist RT(R)(VI) role at Rush University Medical Center, where she focused on interventional radiology and cardiac catheterization. She holds a bachelor of general studies from North Park University.

Path in Advancing Imaging Solutions

I began my career in X-ray in 2005, eventually progressing to CT and then interventional radiology, where I spent about ten years. My work in the stroke field brought me from Chicago to California. After being hired as a manager, I transitioned into the director role upon the retirement of my predecessor.

Currently, I oversee all diagnostic imaging modalities at Tahoe Forest, managing a team of approximately 65 employees across 17 cost centers. My responsibilities include investigating new equipment, handling budgeting, and engaging in strategic planning for the future. I also provide day-to-day support for staff, working closely on new equipment purchases. Together with our physicians and staff, we evaluate options based on cost, functionality, efficiency, safety, and service agreements before making decisions.

Navigating Equipment Purchase Hurdles

Our biggest challenge at Tahoe Forest is staffing, particularly in a mountain town environment. While we have strong employee retention, recruiting new talent remains difficult. Recently, we have seen an uptick in applicants for CT and X-ray positions, which is promising, but attracting qualified candidates is still a struggle. As an administrator, I’m focused on incentivizing retention and improving our management systems to enhance the visibility of our goals and align them with our values.

This approach aims to engage staff and motivate them toward our hospital's mission for the community. We also monitor turnaround times for CT and ER services to ensure prompt diagnoses for our patients. Finding and retaining onsite radiologists is another challenge in this competitive landscape, and our leadership team is actively addressing these staffing issues.

Securing funding for equipment purchases is another significant hurdle, particularly for a hospital. We have successfully utilized grants, like one from Nevada, to refresh equipment at our sister hospital. Given our staffing challenges, we prioritize equipment with automated functions that can reduce the workload for technologists and enhance patient throughput. We must maintain high-quality standards while ensuring vendors provide strong support services to improve operational efficiency.

The Future of AI in Radiology

Currently, AI in radiology serves primarily as an assistive tool. It enhances radiologists' confidence in negative findings, indicating when no abnormalities are detected. However, radiologists still need to review the images, as their expertise remains crucial in the dictation process. While AI streamlines the dictation of negative studies, positive studies still require the same amount of effort. AI helps identify areas that need more attention, enabling radiologists to focus on those while also reviewing the rest for any overlooked details.

We are still in the early stages of AI development, but it will evolve significantly, leading to increased confidence in these platforms as they aggregate more data. On the technologist side, we are exploring automated reconstructions for cross-sectional imaging and seeking equipment that can operate without a technologist. This is particularly important for us as a critical access hospital, where we often have only one technologist on duty overnight. If there are surgeries, this individual must cover CT, X-ray, and potentially set up the C-arm in the operating room.

To address this, we are considering AI-enabled C-arms that can store surgical positions. This would allow surgeons to take control during procedures, minimizing delays and ensuring immediate response in emergencies like strokes or traumas. By enabling this handover, we can avoid additional anesthesia costs and streamline overnight workflows without overburdening our existing staff or requiring extra on-call hours. This flexibility is essential for maintaining efficient operations in our hospital.

Importance of Security Assessments

I believe AI will significantly impact the future of diagnostic imaging. As I explore its full potential, I hope it will optimize our workflows through its automated movements and Bluetooth capabilities. However, maintaining security is a top priority as we implement these new technologies.

When integrating AI and wireless tools, we must ensure that vendors meet hospital specifications and can collaborate effectively with our IT team. There have been instances where products did not meet our security requirements after review. That's why it is crucial for me to look at the security aspect when evaluating new technologies.

Staying Ahead in Diagnostic Imaging

I successfully gathered end-of-life terms for all equipment in our diagnostic imaging department and presented estimated budgetary costs to our CFO. This allowed us to strategically plan our equipment refresh over the next eight years. Building strong relationships with vendors is crucial. They can provide insights into what we need and inform us about upcoming products and discontinuations.

Before I assumed my role, a CT scanner that was already about eight years old when it arrived was installed. Now, ten years later, it is outdated and unreliable. Investing in the latest technology is essential to avoid purchasing equipment that becomes obsolete shortly after installation. My key advice for any director planning a diagnostic imaging equipment refresh is to prioritize vendor relationships to stay updated on market trends and innovations.