CurveBeam AI Cast

Dr. Lew Schon, MD, makes his debut as guest host on CurveBeam AI Cast in an interview with his former fellow, Dr. Cesar de Cesar Netto, MD, PhD. The two reminisce about how Dr. De Netto was first introduced to WBCT imaging at Medstar Union Memorial Hospital in Baltimore, and how he is now a global leader in WBCT research and applications.

The two discuss:

Dr. de Netto's research into progressive collapsing foot disorder (PCFD) and how WBCT could guide treatment, for example fusion vs. joint preserving procedures.

Whether Dr. de Netto thinks all foot & ankle studies will eventually need to be redone using WBCT (spoiler: yes).

How Dr. de Netto's patients are specifically seeking him out to assess their foot & ankle pain with WBCT imaging.

Click here to read about a research project in which Dr. de Netto's team combined WBCT imaging with coverage mapping and distance mapping to better understand bone positioning in patients with progressive collapsing foot deformity (PCFD).

Dr. Cesar de Cesar Netto is an Assistant Professor at the University of Iowa, Carver College of Medicine, specifically in the Department of Orthopedics and Rehabilitation. Dr. de Cesar Netto has had four Clinical Fellowships, including at the University of Sao Paulo, the University of Alabama, the Hospital for Special Surgery in New York, and the Medstar Union Memorial Hospital in Baltimore. He specializes in Foot and Ankle Surgery Disorders and Imaging of the Foot and Ankle, with a focus on Flatfoot Deformity, Tomography and Achilles Tendinopathy.

KEY POINTS:

• Compliance ensures facilities are abiding by government and insurance regulations.
• Facilities must be in MIPPA compliance to bill CMS insurance programs.
• All interpreting physicians must have a state license for the state they performed their exam.

The medtech landscape is constantly evolving. Keeping up with those changes to maintain accreditation standards can be a challenge. CurveBeam AI’s Vinti Singh recently sat down with Nancy Davis to discuss how the Intersocietal Accreditation Commission (IAC) ensures it helps orthopedic practices through its accreditation process.

Davis is a technologist trained in Radiography, MRI, and CT and worked in direct patient care for 30 years. Before joining the IAC as the Director of Accreditation for the CT Division at (IAC), her last role was as an imaging center manager handling radiology and compliance.

Advanced diagnostic modalities in outpatient settings such as orthopedic clinics require accreditation to satisfy the Medicare Improvements for Patients & Providers Act (MIPPA) mandate issued by the Centers for Medicare Services (CMS).

“The main areas we assess are medical and technical staff credentials,” Davis said. “We also look at safety policies and procedures, such as your pregnancy screening and radiation safety policies. We also look at quality assurance practices, including business surveys and routine quality control scans." IAC also examines image and report quality.

One current growth area at the IAC is orthopedics. “We recognize the need for orthopedic facilities to have the representation and accreditation so they can grow their practice,” Davis said.

To that end, IAC recently added the American Orthopaedic Foot & Ankle Society (AOFAS) as a "Sponsoring Society." Sponsoring societies do not provide monetary funding to the IAC. Rather, they designate a member to sit on the IAC's Board, a multi-disciplinary group that provides guidance on new standards.

The AOFAS appointed Christine Seaworth, MD, a foot & ankle surgeon in private practice in Knoxville, TN. Dr. Seaworth also holds the position of Clinical Assistant Professor at University of Tennessee Medical Center Knoxville.

"She's a great representative because she understands the challenges of private practice and practices at university," Davis said. "And it's just sometimes that those two worlds have a hard time connecting."

Societies interested in becoming a sponsoring society member can reach out directly to Davis, and she can initiate the process.

IAC had an abstract on display at the recent AOFAS Annual Meeting, held in Quebec City in September. IAC reviewed accreditation applications from orthopedic practices and discovered that it helped 63% of orthopedic practices improve their policies and procedures. Only 10% of practices had issues with image quality, which IAC also assisted with.

KEY POINTS:

• The mentor/mentee relationship is critical in advancing medicine and technology.
• Significant technological developments in bone health imaging help predict fractures.
• As the density of bone goes down, the risk of fracture increases.

CurveBeam AI Medical Director - Endocrinology Prof. Ego Seeman recently sat down with Vinti Singh, CurveBeam AI’s Marketing Director, to discuss the future of bone health imaging.

Prof. Seeman is a Professor and Endocrinologist in the Departments of Medicine and Endocrinology, Austin Health, University of Melbourne.

He was recently awarded the Gideon A. Rodan Excellence in Mentorship Award at The American Society for Bone and Mineral Research (ASBMR) 2022 Annual Meeting in Austin, Texas.

Dr. Seeman said his own mentors have played an integral role in shaping his career. He first became interested in bone and mineral metabolism during his post-doctoral fellowship at the Mayo Clinic in Rochester under Professor B Larry Riggs.

“I learned so much," Prof. Seeman said of his experience at Mayo. "I made wonderful friends that I still have today, and I recommend to every young person to move out of their local town and get into the world.”

Prof. Seeman also discussed the current paradigm of bone health imaging, and where analysis based on high resolution peripheral quantitative CT imaging holds promise for better detection of those patients at risk for a fragility fracture.

"The technology is such that the radiation exposure has been minimized and allows us to measure the very fine architecture...of the bone," Prof. Seeman said.

In the lead-up to CurveBeam’s Annual User Meeting, initially planned for mid-October, 2022, CurveBeam Connect sat down with featured speaker Dr. Tom Turmezei, Ph.D., a consultant MSK Radiologist at Norfolk and Norwich University Hospital, UK. He joined host Vinti Singh to preview some of the great content he planned to share. (Note: The CurveBeam User Meeting has been postponed to Spring 2023.)

Dr. Turmezei is a founding member of the Computed Tomography in Osteoarthritis (OCTA) Research group.

He also serves as Radiology Representative on the Board for International Weight-Bearing CT Society.

Dr. Turmezei recently returned from Tokyo, where he presented his research at the 16th International Workshop on Osteoarthritis Imaging.

“What has been absolutely pleasing to see is weight bearing CT is forming a much larger part of the agenda,” Dr. Turmezei said.

Traditionally, MRI dominated radiology-led conversations at these types of meetings, but radiologists are beginning to embrace where CT and WBCT can provide unique insights, Dr. Turmezei said.

Dr. Turmezei's own research has been focused on predictors for hip osteoarthritis, and CT has been helpful on identifying morphology characteristics that could point to who may need a hip replacement in the future.

In the lead-up to CurveBeam’s Annual User Meeting, initially planned for mid-October, 2022, CurveBeam Connect sat down with featured speaker Dr. Tom Turmezei, Ph.D., a consultant MSK Radiologist at Norfolk and Norwich University Hospital, UK. He joined host Vinti Singh to preview some of the great content he planned to share. (Note: The CurveBeam User Meeting has been postponed to Spring 2023.)

Dr. Turmezei is a founding member of the Computed Tomography in Osteoarthritis (OCTA) Research group.

He also serves as Radiology Representative on the Board for International Weight-Bearing CT Society.

Dr. Turmezei recently returned from Tokyo, where he presented his research at the 16th International Workshop on Osteoarthritis Imaging.

“What has been absolutely pleasing to see is weight bearing CT is forming a much larger part of the agenda,” Dr. Turmezei said.

Traditionally, MRI dominated radiology-led conversations at these types of meetings, but radiologists are beginning to embrace where CT and WBCT can provide unique insights, Dr. Turmezei said.

Dr. Turmezei's own research has been focused on predictors for hip osteoarthritis, and CT has been helpful on identifying morphology characteristics that could point to who may need a hip replacement in the future.

Fall is coming, and so is CurveBeam’s Annual User Meeting, held this year from Oct 17-19 in Kent Island, MD. CurveBeam’s Director of Marketing, Vinti Singh, sat down with one of this year’s featured speakers to preview some of the great topics attendees of the meeting can expect to hear and learn. Dr. Sudheer Reddy, MD, an Orthopaedic Surgeon from Rockville, Maryland, specializes in foot and ankle conditions.

While Dr. Reddy performs general orthopaedics, most of his work focuses on the foot and ankle. Dr. Reddy has utilized the CurveBeam weight-bearing CT user in his practice for the past five years. “I started using it in 2017 when I came to Rockville, and it was one of the requirements that I wanted in place, knowing the technology, and knowing the potential it had for foot and ankle surgery,” Dr. Reddy said.

The hospital Dr. Reddy’s practice is associated with recognized the mutual need for the weight-bearing CT scanner, so they acquired the system as a joint venture. The hospital purchased the system, and because Dr. Reddy is a firm believer in the technology, he helps promote it to other orthopaedic surgeons who may not know about its advantages.

Dr. Reddy said that most foot and ankle patients do not know what CT scans are or why they need to be weight-bearing. The American Orthopaedic Foot & Ankle Society website is a resource for people to understand better foot and ankle pain, injuries, and treatments. The site contains various articles. “One of the ones I did was on weight-bearing CT scans, where it’s a simple question and answer-based article that patients can read through in a few minutes and at least have some idea of what it is, and why we get it, how it’s important,” Dr. Reddy said.

To learn more and register to attend CurveBeam's Inaugural User Meeting, visit CurveBeam.com today.

In this final episode featuring Dr. Cuellar, Co-founder and Chief Biomedical Engineer for Efferent Health who is also an orthopaedic surgeon specializing in hip and knee replacement surgery spoke to Vinti Singh, Director of Marketing at Curvebeam about cybersecurity requirements and much more.

The conversation opened with a look into how Efferent Health builds layers of security with its partners to protect its clients. However, Dr. Cuellar first acknowledges associated with effective cybersecurity measures.

“I think it would be irresponsible to say, you know, nobody can break into our system because there is now a population of billions of people. There's a lot of smart ones and we can see by what's happened here in the US and elsewhere that hackers can hack into anything,” said Dr. Cuellar.

To combat this, Efferent Health works with 3rd party middleware developers such as Citrix to establish secure VPNs (Virtual Private Networks). Then they start layering middleware technologies to address the multiple vulnerabilities that give hackers the opportunity to compromise systems and gain access to valuable data. The challenges associated with creating these robust security protocols make it very difficult for an average institution to manage and afford.

Dr. Cuellar went on to speak to the importance of effective security measures noting that technology issues take up a significant portion of his time. He spoke to the rarity of going through a day without challenges such as log-on issues.

“I consider current systems to be so obstructive and that's really the massive pain point. It's every single day I spend less time, much less time with my patients and more time trying to make a document correct” for example said, Dr. Cuellar.

Dr. Cuellar and his colleagues at Efferent Health work with multiple partners to address these concerns and develop IT solutions to increase productivity while reducing costs within the healthcare system.

One of healthcare’s biggest expenses is in the processes utilized to run systems and provide patient care. Dr. Cuellar, Co-founder and Chief Biomedical Engineer for Efferent Health who is also an orthopaedic surgeon specializing in hip and knee replacement surgery spoke to Vinti Singh, Director of Marketing at Curvebeam about the antiquated processes driving up the cost of healthcare throughout the US.

In the 2nd episode of this 3-part series, Dr. Cuellar noted that current processes are a lot more cumbersome than they need to be. Additionally, “it seems that today's healthcare applications counterintuitively automate the already distorted systems. Although harsh, I came to this grim conclusion after compiling and analyzing the financial healthcare data in relation to the financial information technology data,” said Dr. Cuellar.

The conversation continues to recognize that a lot of IT companies are creating applications that automate “existing processes without even examining whether the existing process is the right way to do it in the first place right.” He continued to point out that “everything in healthcare except the act of actually providing medical service is riddled with distorted processes communication barriers as well as inadequate and cumbersome data management.”

These processes helped to create “an expensive and massive dysfunctional industry. The monetary incentives to protest the pay into healthcare system are such that the industry is destined to fail.” This led Dr. Cuellar to begin investigating the idea of “building an organization that provides infrastructure and digital services to enhance the delivery of medical goods and services that are better, more efficient, and less costly than the current system.”

And Efferent Health was born. A company that is dedicated to improving healthcare systems for both providers and patients. “Efferent’s proprietary SmartLink (Patent Pending) solution facilitates PHI transfers, including images between healthcare facilities, device manufacturers, and other stakeholders without massive servers and resource allocation. SmartLink uses the latest encryption and HIPAA high-tech transfer technology to move data up to Efferent’s platform in Microsoft Azure.”

When it comes to healthcare in the US, there is little doubt that the economics behind the system is somewhat of a mystery. With the rise in AI, IoT, and machine learning technologies, one would think the cost of healthcare would be on a downward trajectory. However, the reality is completely opposite.

Vinti Singh, Director of Marketing at CurveBeam, sat down with Dr. Alberto Cuellar, Co-founder and Chief Biomedical Engineer for Efferent Health who is also an orthopaedic surgeon specializing in hip and knee replacement surgery to discuss the fiscal well-being of the healthcare system. The conversation was so engaging that it turned into a three-part series.

Dr. Cuellar, once in private practice, decided to join Baylor Saint Luke’s Medical Group to continue serving patients due to the financial challenges associated with working in the private sector. He shared his knowledge in a 14-year economic study on private-practice orthopaedics at the 2013 American Academy of Orthopaedic Surgery Annual Meeting, which won best poster presentation.

“In the early 2000s anecdotally, I noticed the dropped an income from our professional services in our orthopedic group. In addition, we became more reliant on ancillary services such as partial ownership of a surgical facility, X-rays, MRIs, physical therapy, braces, and other medical equipment,” said Dr. Cuellar.

Initially, the study was meant to understand the financial dynamics of his group practice, but it evolved into finding ways to make prudent financial and operational decisions utilizing data. His work illustrated inefficiencies within private practices that were simply not sustainable. Singh noted that the “cost of technology and the efficiency that technology has afforded us has increased over time.” And one would think that if “healthcare was properly leveraging technology would have also in the inverse decreased but that is in fact not the case health care costs are rising.”

Dr. Cuellar’s work illustrated that healthcare costs actually rose 3000% between 1970 and 2018. With all these factors in mind, it’s no wonder Dr. Cuellar decided to use his expertise to found Efferent Health where technology automates healthcare systems to reduce costs and increase efficiency.

Those in the medical field who have heard of or used weight bearing computed tomography (WBCT) should prepare themselves. From October 17 through 19, the first in-person user conference, Weight Bearing CT: New Directions, will be held at the Inn at the Chesapeake Bay in Kent Island, Maryland. WBCT is relatively new modality, but has been validated in multiple peer-reviewed publications and is now moving more mainstream. Vinti Sigh, Director of Marketing at CurveBeam, joined Host Daniel Litwin to provide insight into what the conference will entail.

“As is becomes more of an established technology, now we’re asking questions that are deeper than, ‘Does it work? What can I use it for?’” Singh stated. Now, gray areas include topics such as billing, authorization, utilization, proper referral education, and issues with state and federal requirements, to name a few. “What a lot of our customers maybe don’t get from the podium at scientific conferences is how to translate that into real clinical practice,” Singh stated. The conference will also examine how WBCT is revolutionizing several specialty areas, including sports medicine and pediatric applications.

A networking cocktail reception will occur the first evening of the conference, followed by a full day of sessions. The conference will be split into three categories: Inspirational, which will provide insight into future applications such as custom insole design. The Clinical component will include an in-depth look at billable indications, and the last component, Operational, will address practical subjects for implementation and utilization.

“With WBCT, you’ve made a major capital investment and you want to make sure that you’re getting the most out of your system, so this will give you that, while also hopefully creating opportunities to make friends from around the country and maybe even around the globe with the same mission,” Singh summarized.

Singh said CurveBeam is currently finalizing the agenda and is looking for speakers. Potential attendees may fill out an online form to express interest in conference participation and receive registration information; that form is located here. Those interested can also email [email protected] for more information.