Perspectives from ISB

The past year and a half was a year of uncertainty. As we await the third wave and more, I introspect how the pandemic has affected our workplace behaviour, mental wellbeing and work-life balance drastically.

The graphic below is a reflection of our journey in radiology.

Learnings from the past year: From being a vestigial arm of healthcare during the early days of Covid-19 with low work volumes in imaging, the radiology community was hurled into this battle of uncertainty.

Tackling initial anxiety at work: Due to the initial fear of working in Covid-affected areas, radiographers and consultants had Zoom meetings and weekly briefings on policy changes and Covid-19 care. The supply of adequate PPE and sanitisation/ disinfection practice in all sections of radiology was a positive for the teams. We segregated Covid from non-Covid care delivery pathways and introduced norms of practising safe and smart imaging. We reduced the imaging waiting, overcrowding, and scan cycles to minimise exposure to all stakeholders.

Leveraging digital radiology in Covid care units: We moved slowly to capitalise on X-ray radiology to assist the diagnosis and surveil Covid pneumonia. Digital mobile X-ray machines were procured on lease and moved into isolation wards and critical care units as the point of care support. The critical care workforce was trained to take radiographs in case of emergency. USG/Doppler protocols for fast USG for abdomen, thorax, and fluid challenge was encouraged.

Healthcare IT transformationIT was a great enabler during the pandemic. X-ray transfer was enabled on digital devices and mobile devices. Hospital radiology became paperless. The wi-fi enabled seamless and rapid image data transfers reduced people and asset movement in the isolation areas.

Adoption of AI: Phone calls from EMO were non-stop and 24X7. Radiology was weaponised to battle the virus with machine learning and artificial intelligence. We introduced voice recognition bots for reporting via desktop as well as mobile devices. In the early days, we were trying to study the X-rays of lungs, comprehensive reports, and print correct findings to solve the treating dilemmas. As weeks flew by, we matured from X-ray to HRCT scans. We created reporting standards, smart reporting, adopted global guidelines, and consensus statements were structured with colleagues in the field.

HRCT became the mainstay for early diagnosis and prognosis in Covid-19 pneumonia.  We partnered with AI companies to use X-ray as well as HRCT triage for reducing the reporting TAT to assist in fast-tracking admissions as well as home care. Our secondline healthworkers were fast-tracked into respiratory and ENT radiology like Netflix and  Amazon Prime hit India in 2020. Our uncertainty has now evolved into confidence, well-armed with the best tools to fight this war.

Making waves in deep tech space: The pandemic opened opportunities for research and scientific deliberations all over the world. We capitalised on moving ahead to partner with big data and deep tech industry to make waves overseas and in India, by collaborating with Japan.

As we faced the second wave, Mucormycosis hit India hard. Once again, radiology geared up for another battle, this time around with MRI and contrast studies for evaluating the impact of Fungal Sinusitis. Our priority has shifted from keeping ourselves safe to keeping the community safe. Post vaccination, our teams feel more safe and secure and are brimming with renewed confidence. Needless to say, the pandemic led to the introduction of the right tools and their rapid adoption. And, this will transform the future of digital radiology.

(This blog is contributed by AMPH Co 2020 alumnus Dr. Avinash Nanivadekar, Head Radiologist & Chief Digital Officer, Grant Medical Foundation, Ruby Hall Clinic, Pune. Read his story here.)

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