Wilson, an Air Force veteran who has advised the Congressional Black Caucus on issues like health equity, talks about the evolution of diagnostic and imaging services.
HealthLeaders recently caught up to Cedric Wilson, MBA, RT, an executive director at Stanford Medicine Children's Health, for a virtual chat about the evolution of diagnostic and imaging services and the role that innovation plays in this segment of the healthcare industry.
Wilson served more than 20 years in the Air Force, and he has spoken with and supported the Congressional Black Caucus on issues ranging from health equity to opportunities for minorities in healthcare.
Q. You're leading the Diagnostic Imaging Innovations effort at Stanford Medicine--tell me a little bit about that. What do you focus on?
Wilson: My role is an incredibly rewarding one. I am the executive director of diagnostic and imaging services at Stanford Medicine Children’s Health. At its core, it constitutes leading diagnostic testing and imaging strategies, navigating the evolving continuum of care surrounding chronic diseases, and moving to preventative approaches in healthcare.
All of this is underpinned by research. I oversee about 180 or so experts that cover all facets and all modalities of radiology, as well as developing a leadership team. As an aside, I also spent more than 20 years in the United States Air Force, and in that role as a senior leader and superintendent, [in] the Pacific as well as Europe. This, along with my background, drives a large part of my service mindset and work promoting health equity, healthcare education and policy strategy in my work as a speaker at the Congressional Black Caucus.
Q. How have new technologies and strategies changed diagnostic imaging?
Wilson: Radiology in a children’s hospital differs from that in the adult setting. The majority of patients who receive MRIs, for example, are adults, so the equipment on the market and tools developed reflect that. Those are not always best for children or young adults. Sticking with the MRI example, children find it harder to sit still, they are smaller, they breathe faster, and more. This makes clear imaging challenging.
Cedric Wilson, MBA, RT, executive director of diagnostic and imaging services, Stanford Medicine Children's Health. Photo courtesy Stanford Medicine Children's Health.
Recent innovations in MRI equipment were a must. We’ve collaborated with engineers at UC-Berkeley to produce new designs and methods for smaller equipment. Flexible, lightweight MRI signal-receiving coils that increase imagery for children and lower scan times. Adding to this are advancements in image-reconstruction algorithms. Motion-correction sharpens images and artificial intelligence reduces scan times by using computer technology to reconstruct MR images with less raw data. We’re seeing large time savings across cardiac and oncologic examples, for example, with scans now able to be completed in 10 or so minutes versus an hour.
Q. What are the biggest challenges or barriers faced by radiology providers?
Wilson: A major challenge that has risen to prominence over the past few years is disparity in education and understanding of radiology among diverse populations. This didn’t happen overnight; it was passed from generation to generation.
For example, for many minorities or culturally diverse patients and families, there’s a fear of going to the doctor or of having diagnostic tests. This runs the gamut from X-Rays to MRIs and many tests in between. It hinders the industry’s ability to catch diseases early or provide optimal care plans. Many radiology departments, including ours at Stanford Medicine Children’s Health, deal with some of the most critically ill and rare cases from around the world. We’re working hard to lead the industry in dispelling myths and promoting education around radiology. This extends to engaging our patients in new ways to understand their unique cultural behaviors. This will empower healthcare to better care for increasingly diverse patient populations. It remains a core component to an equitable health future.
Q. How can these new technologies or strategies improve clinical outcomes?
Wilson: One of the goals of technology in radiology is to limit (or, in some cases, eliminate) a child’s exposure to radiation. Another is to improve diagnostic capabilities.
A good example of this is how we’ve developed a way to test for vesicoureteral reflux, a kidney condition that impacts approximately one in 10 children, without the use of radiation. Another would be pioneering the use of PET/MRI instead of PET/CT scans in pediatrics. This strategic approach limits radiation exposure and eliminates the need for separate appointments — and because it provides more information to our experts in relatively the same amount of time, it enables a more accurate diagnosis and faster time to providing the right treatment options. Our team also participates in the Image Gently campaign, which seeks to reduce radiation exposure in pediatric imaging across the nation.
Q. How can these new technologies or strategies improve provider workflows and reduce stress?
Wilson: Any radiology innovation must be considered as supplemental to a diverse, multidisciplinary care team that accounts for the holistic well-being of patients. The high-acuity, critically ill patients we work with are children or young adults. They are growing and experiencing trauma during transformative years of their lives. There’s a lot more that goes into caring for them than simply treating an ailment or disease. So new imaging technologies and techniques capture images with increasing levels of detail, clarity, and speed. It gets the right people in the room earlier on in the process. This shares the load when it comes to caring for patients and puts experts in a position to maximize their impact.
Q. Is there a shortage of qualified technicians for this field? What steps might be taken to ensure the stability of the workforce?
Wilson: On the theme of health equity and how that impacts radiology, a lack of education also extends to the opportunities to work or build a career in radiology.
Radiology is quite unique in that so much of the profession is driven by technology--and how to then empower caregivers with information to better care for patients. I have spent a lot of time over the past few years explaining my journey to people and educating others to the modalities in radiology. Two reasons: First, there are non-traditional ways into radiology, and we need to be open to inviting all types of talent into our field. Second, the industry doesn’t do a good enough job of highlighting the computer science elements of our work. Behind the bench and bedside care that upholds radiology is an intricate and innovative layer of computing and imaging systems. Do you like technology? Then wonderful, there’s potential in radiology. You’re looking at a future in artificial intelligence, machine learning, or cloud computing systems? We offer that, too.
Q. How will radiology fit into the hospital of the future?
Wilson: Radiology will remain critical in the hospital of the future.
The earlier and more specifically imaging can identify potential illness or disease, the more opportunity that opens up to provide the right care. I believe it will fundamentally change how we care for patients across the healthcare continuum. For example, we are currently planning imaging around enamel to assess brain function at a younger age. This information can be used to better predicted disease before the child ages, leading to earlier treatment potential.
Radiology is also moving into care models that enable multidisciplinary approaches to healing. This includes not only the AI, ML, or advanced technology applications we’ve discussed earlier, but also broader conversations around systems, operations, and education. For multidisciplinary or holistic care strategies, we’ll see radiology play a critical function in care, accompanied by providers from other specialties or domains. Think mental health, physical health, emotional health, and more.
Q. What new technologies or strategies are on the horizon? How will this field evolve?
Wilson: I am glad that you mentioned strategy within this question. Often in pediatrics, strategy is just as important as research and technology innovation.
Here’s an example that shows how strategies are evolving to provide better care to patients. Years ago, we discovered that children who needed an MRI for orthopedic indications had a slow and cumbersome experience with the healthcare system. The child and parents would take a day off from school/work to see a specialist, who then requests an MRI. Then the families go home, wait for insurance pre-authorization, and then take another day off to come for the MRI.
So the radiology and imaging team worked together to innovate a new process that leverages our understanding of MRI physics and uses high-performance computing to enable the MRI to be done in under 10 minutes. That, coupled with a new process that waives insurance pre-authorization, allows immediate walk-in MRIs. Instead of care taking days or weeks, now we can take just a single visit to set a child on the path to recovery.
“The earlier and more specifically imaging can identify potential illness or disease, the more opportunity that opens up to provide the right care. I believe it will fundamentally change how we care for patients across the healthcare continuum.”
— Cedric Wilson, MBA, RT, executive director of diagnostic and imaging services, Stanford Medicine Children's Health.
Eric Wicklund is the Innovation and Technology Editor for HealthLeaders.
Cedric Wilson is an executive director at Stanford Medicine Children's Health, heading up the health system's diagnostic and imaging services.
Wilson says innovation is central to radiology at a children's hospital, and that it's much different than radiology for adults.
He also noted that different populations and cultures see radiology differently, so providers need to adjust how they discuss the procedure.