Reflection, Surface and Material – What Lays ‘Beneath the Transparent’

HughTurvey_3_VLAs X-Pose Material and Surface Xogram exhibition opens in London, X-ray artist Hugh Turvey uses the exhibition themes to explore ways we can improve hospital environment through art.

Reflection
Four years ago I staged my first large public exhibition titled X-perimentalist. I rather fancied myself as a pioneer and wanted to reach out, to establish an audience who would appreciate the aesthetic of science and the emerging modality arts. I had come from a photographic background and wished to gain momentum for my work, as the earlier photographic pioneers had done before…a matter of classification, understanding and appreciation.

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So how did it turn out? Overwhelming, humbling and surprising …most notably an amazing relationship with the oldest radiological society in the world and a series of healthcare projects were born…I metaphorically became a dad again with a series of new challenges of language, communication and expectation to innovate a new visual concept of ‘transparency’ between practitioner and public. Modality art is the perfect medium that visually embodies the science and when presented artistically can elevate, educate and orientate.

Surface
Radiotherapy_UCH_HughTurvey_HiddenGarden_0012_Layer Comp 13The concept of revealing truth is one of the simplest structures in storytelling. Everyone loves a good story and the discovery of character hidden in sometimes the most unlikely places. When you read ‘cover to cover’ you physically move through the book absorbing matter on your journey. This absorption is compelling and second nature to us. You lose yourself in it.
But I find medical/healthcare environments not easy to read. The covers are not enticing, the pages are not printed correctly or in a language I do not understand and I can’t focus on the story line. I have orientation problems and am most happy when I put the book down.

As Professor Gary Royle, from University College London says “We should consider whether there are any innovative developments we can propose around patient experience, in particular for the paediatric patients. The hypothesis is that some studies have indicated that this can potentially have a positive effect on the patient mood / experience and so could be beneficial to the patients / treatments / staff.

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And here’s an idea of what could be done……

1. Explore the creative potential in the area between medical knowledge, understanding and use of modality art and the artists’ understanding of images and their power to communicate.
2. De-mystify the processes and technology used in diagnostic imaging to help engage patients, increase their understanding of the science and to help staff in communicating with them.
3. Produce artwork that is meaningful and engaging for patients, staff and visitors.
4. Develop a pilot/prototype educational tools which can help radiology staff in their work and benefit patients and the wider radiology community nationally.
5. Further artistic discourse and the debates surrounding art and science collaborations.
6. Aim to contribute to a re-engagement between the public and contemporary biomedical imaging techniques.
7. Implementation of new immersive way-finding, signage, feeds and curated digital art systems.

Transparent
Four years later, I know less having now seen the bigger picture.

Visit the exhibition at:
Xpose
gallery@oxo, Oxo Tower Wharf, Bargehouse Street, South Bank, London, SE1 9PH
Dates: 12 February – 23 February 2014
Opening Times: 11.00am – 6.00pm
Admission: Free

About Hugh Turvey’s Xogram work
High Turvey is an artist with an international reputation. His Xogram work is held in public and private collections throughout the world. Bridging the gap between art and science, graphic design and pure photography, it has been utilised in myriad applications, including, commercially, for marketing and advertising, in TV and film and by architects and interior designers.

Along with developing a body of work for the Science Photo Library, Hugh Turvey has collaborated on an ebook and iPad app called ‘X is for X-ray’ launched at the Radiological Society of North America (RSNA) in Chicago. His Xogram work has also been widely featured in newspaper articles and magazines around the world.

Among his commercial projects, he has made six award-winning TV adverts, using ground breaking Motion X-Ray. For the past three years he has been working with Waitrose UK on celebrity chef Heston Blumenthal’s ranges and has had images commissioned by L’Oreal, Paris.

Special thanks to: Senior Radiographer Sasha Moore YDH + Imaging Dept, Prof. Gary Royle UCL, Dr. Martin Fry UCL, Julia Solano + Radiotherapy Dept. UCLH, Niki Whitfield + Gloucestershire Oncology Centre Cheltenham and all the other hospital Trusts currently touring the Wellcome Trust inr-i project.

A look back…and forward

Charlie McCaffrey 7Charlie McCaffrey, from Carestream Health reviews the world of medical imaging in 2013 and takes a peek of what lies ahead in the new year.

The dawning of a new year provides an opportunity to look back and reflect on the previous year. Surveying the diagnostic and therapeutic imaging landscape in the UK, 2013 was an interesting year. The publication of the Francis Report in February was a pivotal moment that will have long lasting consequences for the NHS. February also saw the official opening of the BIR’s new premises in St John Street and I was privileged to be in attendance at the opening ceremony and attend my last Council meeting as a Trustee there in September.

Liverpool hosted the UKRC in June for the first time and the event was a huge success.

In August, the government announced a commitment to establish two proton beam therapy centres by 2018: an exiting development for UK cancer treatment and the imaging community as a whole. August also saw the publishing by the DoH of “Better Procurement, Better Value, Better Care: A Procurement Development Programme for the NHS” which aims to build a modern, effective and efficient procurement capability in the NHS that is among the best in the world.

On the business front, we saw unprecedented activity in the RIS, PACS and Vendor Neutral Archiving space, with what can be described as a tsunami of implementation activity in the first half of the year as many NHS Trusts in the southern cluster and the North West and West Midlands cluster of the Connecting for Health Programme opted to exit the Programme and procure, implement and manage their own IT solutions.

Despite the establishment of the DoH Capital Equipment Fund, purchases of high-end imaging modalities by the NHS continued to be depressed with CT scanners, MRI units and general X-Ray room all failing to recover, a point highlighted elsewhere by my fellow industry bloggers. This will continue to be a challenge for the NHS with an ageing installed base and is a source of frustration given the significant savings being generated through the closing of the Connecting for Health Programme. It is imperative that these savings are channeled into investment in innovation to enable patients and staff to benefit from the faster throughput, lower patient exposure and lower total cost of ownership offered by new imaging modalities.

Looking forward to 2014, the NHS will continue to be a challenging environment in which to work and operate. The move to 7-day working will continue to accelerate against a continually challenging economic environment. More NHS Trusts are expected to exit the Connecting for Health Programme. On the technology front, imaging modalities will become more compact, efficient and faster, have higher throughput and lower dose and be more flexible. Healthcare IT solutions will become more portable, feature-rich and integrated. And on the political front there is the not insignificant matter of the Scottish referendum on independence in September, something, as a native Glaswegian, I will watch with much interest!

In closing, I would like to take this opportunity to wish the BIR continued success for the future and wish you a Happy New Year.
Charles McCaffrey, Cluster Manager – North Europe and Managing Director UK & Ireland, Carestream Health.

Carestream

(Charlie is also Chair of AXrEM—the Trade Association of Healthcare Technology Providers for Imaging, Radiotherapy and Care)

Powerful partnerships

Sophia Anderton, Head of Publishing, BIR

Sophia Anderton, Head of Publishing, BIR

Sophia Anderton, BIR’s Head of Publishing reflects on a week of diversity and partnership at RSNA 2013 in Chicago.

They say Chicago’s the windy city, but last week it was more like the freezing metropolis!

Fresh back from RSNA, one of the world’s largest medical conferences, boasting 20131205_150111more than 30,000 delegates, I’m reflecting on not only the scale but also the diversity within radiology and its allied sciences. The sheer size of the event—so many people gathered together all for the sake of radiology—but also the variety of different disciplines represented were inspiring to say the least. I wonder what Wilhelm Röntgen would have thought of it all?!

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BIR stand on Publishers’ Row

The BIR had a stand in a prime location on Publishers’ row so I was lucky enough to meet with a vast array of different people from around the world, working in diverse disciplines across the field (consultant radiologists, trainees/residents, radiographers, physicists, students and representatives from manufacturers). Everyone had a different story to tell.

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Professor Andrew Jones (left) with the Indian Radiology and Imaging Association President Elect, Bhavin Jankharia

There was great interest in both the BIR and BJR; we were giving away free copies of Best of BJR, highlighting some of the best articles from the last year (they’re all free to download to all until the end of the year at http://bit.ly/1f7GT0c). What really caught people’s attention was our interdisciplinary ethos. As a society and journal uniquely covering all disciplines relating to radiology, there really is something for everybody. We now offer an international membership package and it was a real joy seeing people realise that the BIR could really be for them, and we look forward to working with lots of new people in the future.

With so many people, societies and companies represented, the BIR took the opportunity to make contact with as many of them as possible. For some it was the start of a new relationship, but for others it was an opportunity to reacquaint themselves with long-standing connections. One of the BIR’s newest partnerships is with Health Management (http://healthmanagement.org/) which will be available free of charge to all BIR members from 2014. Look out for the interview with our President, Andrew Jones, early in the new year.

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Grant Witheridge from corporate subscriber AGFA meets up with Professor Andrew Jones

RSNA’s key theme this year was The Power of Partnership and I think that really sums up what I was hearing last week. Working together with energy, vigour and strength to have an influence on the radiological sciences is an important message. In distributing over 1,400 copies of Best of BJR and talking to even more people about publishing, education, events and membership, the BIR is doing its part in promoting the influence and diversity of radiology.

I’m now looking forward to next year and the centenary meeting of the RSNA.

How imaging technology can help tackle the funding challenge facing healthcare

Karl Blight high resKarl Blight, UK and Ireland General Manager at GE Healthcare considers how imaging technology can help tackle the funding challenge facing healthcare

NHS England’s recent strategy paper, ‘A Call to Action’ [1] Identified a potential £30 billion funding gap between spending and resources by 2020-21 if services continue to be delivered as they are now. This challenge will require significant changes in how healthcare is provided so that productivity can be improved and costs reduced.

While much attention will be paid to structural changes around how the NHS is organised, and to where and how patients access healthcare and are treated, funding decision makers need to recognise that investment in appropriate technology can make a major contribution to improving the efficiency of the healthcare system. There is a general misconception that the up-front cost of healthcare technology is prohibitive and, at a time of economic austerity, should be amongst the first areas to be constrained. But, this can be a false economy. Persisting with older technology can lead to higher maintenance costs, disrupted patient appointments due to increased downtime and slower scans, while newer equipment can increase productivity with higher uptimes and better quality images that enable more confident diagnoses and make repeat scans less likely.

Meanwhile, some newer scanners feature state-of-the-art technology that can help save time for clinicians and reduce the burden of paperwork, for example connecting to field engineers who help solve issues remotely so that clinicians can focus on providing patient care. In addition, many medical device manufacturers are investing in the development of new products which have been engineered to meet specific needs at a lower price point. Many are specifically designed to be portable and efficient to operate for the user. Not all situations require the high end technology, and manufacturers are providing equipment that can be tailored to the particular needs of the user or service.

Revolutionary developments in medical technology encompass not only the physical kit. The rise of digitisation, particularly in imaging and in data analysis, transfer and management, is good for the patient and also has huge potential to boost productivity. The combination of big data analytics and clinical information is helping healthcare professionals to identify issues, design solutions and implement patient and system level changes much faster than previously possible. There is a vast reserve of data in healthcare and we are only at the beginning of making the most of it.

The medical device industry, by investing in the development of new technologies, is playing an important role in helping practitioners to deliver better, more cost effective care to patients. Clinicians and technology providers alike now need to ensure that UK healthcare budget holders don’t just focus on the perceived costs associated with new equipment, and instead understand and recognise the value, productivity potential and long term benefits that investing in appropriate technology can bring, both to improving patient care, and to helping the NHS meet its funding gap.

[1] http://www.england.nhs.uk/2013/07/11/call-to-action/

Happy belated 65th birthday

Neil Mesher, Managing Director, Philips Healthcare

Neil Mesher

It is rare for a day to pass when the healthcare system in the UK is not in the media spotlight, and it’s not very often that good news sells newspapers. Indeed, as I write this blog, I notice that the “crisis” in A&E is back on the home page of the BBC, with fears over how prepared the system is for the onslaught of winter, while it’s still 30 °C outside!

 

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Of course, it’s worth remembering that for every newspaper headline, millions of people are cared for and successfully treated by the health service in all its guises, each day.  However, as the NHS turned 65 last month we have to acknowledge that the system does have structural, long-term challenges. Those born in the years before the NHS, the over 65s, currently make up 17% of the population. In the next 50 years that percentage will rise to 27%, with the over 85s set to be the fastest growing part of the population. These statistics are in part a measure of the past success of the NHS, but an ageing demographic, living with multiple long-term conditions, will be a key factor in how its future is shaped.

1948-NHS-leafletThere are many debates in the public arena about how to address these challenges in the coming years. The quality, innovation, productivity and prevention (QIPP) agenda undoubtedly has a significant role to play as a framework for the NHS. The rapid adoption and spread of innovation, supporting better quality care and improvements in productivity are all objectives that the whole of the healthcare “industry” can sign up to. Putting the patient at the centre of this process, supported by appropriate technology and resources, will positively impact patient outcomes.

Radiology has a pivotal role here in delivering accurate and timely diagnosis, enabling clinicians and patients to make informed choices about the direction of treatment and care. There was a fascinating debate on the radio last week about the notion of “too much healthcare”, and it concerned a patient who had been successfully diagnosed and treated for cancer. However, the aggressive approach to his treatment had left him with a number of serious long-term issues which could have been avoided. I was left with a sense that better diagnosis and information could have led to a better patient outcome, and significantly reduced the initial and ongoing treatment costs.

As a manufacturer and provider of healthcare services, at Philips we are working to understand how the QIPP agenda is being implemented at local levels, so that we can deliver tailored solutions. By combining the capabilities of the NHS with the technical expertise and infrastructure of a large multinational company, we believe that we can achieve more together. We are on a quest to develop more innovative solutions that will enable you to collaborate freely, diagnose more confidently and provide care passionately.

Here’s to the next 65 years!

Neil Mesher, Managing Director, Philips Healthcare

Diagnostic Imaging and Patient Choice

Peter Harrison 120 x 100

Peter Harrison

In the first of our guest blogs, Peter Harrison, Managing Director of Siemens Healthcare Sector, talks about how patient choice is driving a requirement for transparency of clinical performance.

The prevalence of internet usage has had a profound impact on patients’ engagement with their own health. Ask any GP and they will tell you stories of patients presenting to them with a confident (often inaccurate) self diagnosis of their conditions based upon internet research. While I am sure that this can frequently be unhelpful, surely the net impact of patients taking more interest in their health must be celebrated?

The internet has empowered consumers. Parents can now easily check Ofsted reports to establish the highest performing schools, and consumer guides before making purchasing decisions. The writing is on the wall—patients and carers will increasingly (and appropriately) position themselves as healthcare consumers and will demand the information to make informed choices on healthcare provision. GPs will provide counsel, but increasingly, patients and carers will also seek direct access to information. We are already starting to see greater transparency of clinical performance at a surgeon level. A good example can be found at the Society for Cardiothoracic Surgery website (http://www.scts.org), where risk-adjusted mortality rates can be viewed down to discrete surgeons, set against a scatter graph plot of their contemporaries.

I anticipate that a similar trend will apply to diagnostic imaging. Consumer demand will drive increased transparency of performance and a range of measures to enable patients and carers to make more informed decisions when exercising choice of provider. Those measures will likely extend to facets of modality performance that support accurate diagnosis (such as spatial and temporal resolution), but I also expect patients to be take a greater interest in wider facets of the imaging experience, such as safety and comfort. When considering modalities that utilise ionising radiation, patients may well want to understand what dose they are likely to receive during a scan. Not unreasonable, but there will also be a responsibility to help patients understand that the radiology team will need to appropriately balance minimisation of dose with the diagnostic quality to ensure appropriate specificity and sensitivity. Perhaps patients will want to establish what dose-reducing technologies are available within the imaging department and the extent to which the technologies are appropriately deployed?

Beyond traditional clinical quality and safety, issues of accessibility will also be of interest, with respect to both waiting times and bariatric considerations. What kind of experience might they expect with regards to patient care and comfort?

As the NHS adopts greater plurality of service provision and extends choice of provider to patients, successful imaging service providers will seek to differentiate themselves by affording due consideration to equipment selection and standards of service. I expect that those who are sensitive to these dynamics will be those who thrive and deliver a sustainable service, dependent upon both clinical referral and patient choice.

Peter Harrison is Managing Director, Siemens Healthcare sector, UK