ASNR President’s Review of 2014

This has been a year of major changes at the ASNR and this review is intended to keep the membership informed. First, there are three ongoing major transitions in personnel. Second, implementation of the Strategic Plan of 2014 is proceeding.

TRANSITIONS

AJNR
Having brought AJNR into the forefront of all radiology journals, with a ranking of #2 in impact factor, Mauricio Castillo will be stepping down as Editor in Chief in June, 2015. I chaired a selection committee for the new editor of AJNR, with the help of James Barkovich, Barton Branstetter, Harry Cloft, Nancy Fischbein, Tabassum Kennedy, Laurie Loevner, Robert Quencer, Alireza Radmanesh, Howard Rowley, Charles Strother, Jody Tanabe, Tina Young Poussaint, and Robert D. Zimmerman, as well as Karen Halm, James Gantenberg, and Angelo Artemakis, from ASNR Headquarters. We were pleased to announce that the new Editor in Chief, starting July, 2015, will be Jeffrey S. Ross, MD.

Foundation of the ASNR (FASNR)
In June, 2015, Howard Rowley will be stepping down from Chair of the Foundation to take on responsibility for the Annual Meeting and Symposium of the ASNR in 2016, as upcoming President-Elect and Program Chair. During his years as Chair, Howard has continued to burnish the work of the Foundation, which is committed to research and education in the field of neuroradiology. Following Howard’s departure, we shall need someone as dedicated to carry on this very important role.

I shall be chairing a committee to select the new leadership of the Foundation, with the help of Burton Drayer, Eric Russell, and Patrick Turski, as well as James Gantenberg from ASNR headquarters. The Administrative Committee has decided to separate the leadership into two branches, with Research and Grants on one side and Funding and Development on the other side. It is clear that with the increase in the number of grants and awards (now totaling 7, with two new proposed grants that would raise the total to 9), overseeing, assessing, and organizing the grants and awards has become a much larger challenge and time commitment than before. With respect to Funding and Development, a more organized and inspired approach has resulted in a substantial contribution increase. These two branches of the Foundation require very different leadership skill sets to optimize continual growth and to adapt to healthcare changes. Therefore, the Foundation will have two divisions, each reporting to the Administrative Committee.

CEO of ASNR
Finally, James Gantenberg, who has been our CEO at headquarters for over 20 years will be stepping down in 2016, necessitating a search for a replacement. Just as with everything else, the challenges of running a non-profit are becoming more complex. Pina Sanelli is chairing a committee, with Mauricio Castillo, William Dillon, Carolyn Meltzer, and Patrick Turski, as well as James Gantenberg, himself, to study the issues involved in order to decide upon the qualifications we need for a CEO for the next 20 years.   

STRATEGIC PLAN

Under the leadership of William Dillon, the Strategic Plan of 2014 has been created to place us in the best position to deal with all the socio-economic changes and forces at work. The full Strategic Plan is on the ASNR website.

The Strategic Plan committees have produced white papers on 6 different issues. Below are the issues and the current status of our implementation of the recommendations.

Issue 1. Demonstrating the value of neuroradiology in healthcare and to society

Study group: Michael Brant-Zawadzki (chair), Dieter Enzmann, Jerry Jarvik, David Seidenwurm, Pamela Schaefer

Current Status:  Recommendations include promoting the standardization of nomenclature for widely prevalent disorders and the inclusion of evidence based prevalence data in reports. I have asked Adam Flanders and Jerry Jarvik to head committees to best develop user-friendly structured reports and a list of scientific publications to be posted on our website for our membership to use. Recent advances in the standardization of the nomenclature include the just published revision of the nomenclature for lumbar spine disc disease, a joint effort of NASS, ASNR, and ASSR. Similarly, a recent study (McCullough, et al., Radiology, v.262, n. 3, March 2012) documented that simply providing prevalence data at the end of a typical lumbar spine MR report for common findings (disc protrusions, degenerative joint disease) could cut the use of opiate prescriptions significantly. The addition of prevalence data in the Conclusion sections of the report for commonly observed “abnormalities” could greatly help add value. We would like to make this information widely available in a user-friendly, effortless way for our members to implement into their daily practices.

On another level, value is increasingly being defined on the basis of cost. I am organizing a committee—a SWAT team of leaders experienced in cost efficacy research—to help further identify and measure value derived from specific common neuroradiological imaging categories, to demonstrate the downstream effects of appropriate utilization management in both health and cost outcomes.

Issue 2. Demonstrating the value of ASNR to members and potential members

Study group: Eric Russell (chair), Mauricio Castillo, Phillip Meyers, Howard Rowley, and Vinil Shah

Current status: Recommendations include investigating the annual meeting structure and cost and reducing the registration fees of the annual meeting. Beginning last year and initiated by Mauricio Castillo, under the leadership of Pina Sanelli, the Budget Committee, composed of Mauricio Castillo, Laurie Loevner, Suresh Mukherji, Howard Rowley, Pamela Schaefer, David Seidenwurm, Robert D. Zimmerman and myself, devised a plan to reduce the ASNR’s budget. Every penny saved was devoted to decreasing the meeting registration fees for our young professionals, namely, those in training or within a few years of completing training. At the Montreal meeting in 2014, these young professionals had a meeting registration fee reduction of up to 40% compared to prior years. This had the beneficial side-effect of a 300% increase in young professional registration above that budgeted. This year, the Budget Committee is continuing its work and we are hopeful to see further reductions.

On the socioeconomic side, it should be noted that the ASNR will continue to keep a close eye on the evolution of health-care developments and to advocate for the role of neuroradiology in all facets of health-care delivery, as well as representing our membership within the larger house of radiology and of medicine. For the central role that the ASNR has played in all this, we have to deeply thank the outstanding job that Robert Barr, Jacqueline Bello, William Donovan, Steven Falcone, Joshua Hirsch, John Jordan, Suresh Mukherji, Gregory Nicola, David Seidenwurm, Raymond Tu, Patrick Turski, and many others have played. Their effectiveness in demonstrating the value of our neuroradiology reimbursements on a national level at the Specialty Society Relative Value Scale Update Committee (RUC) and at the Center for Medicare and Medicaid Services (CMS) levels has been crucial and often not realized by many of our members. The ASNR has been central in these neuroradiology reimbursement issues, for which the ACR relies on us. I thought that our Health Practice Committees were so important that I put into place the constitutional amendment to make the three Health Practice subcommittees full committees with representation at the Executive Commmittee level.

Other recommendations include fostering transparency to keep membership up to date on key society activities. Thus, this report.

Issue 3. Communicating effectively in the digital age

Study group: Barton Branstetter (chair), Tina Young-Poussaint, Ramin Saket, Doug Phillips, Frank Lexa

Current status:  Recommendations include modernizing the website and personalizing utilization of social media. I have asked Max Wintermark and Scott Faro to head a committee including Ari Blitz, James Chen, Falgun Chokshi, Rivka Colen, Adam Flanders, Suresh Mukherji, Anna Nidecker, and Johann Van Goethem. They have analyzed the challenges and are proposing changes aimed at improving not only our website, but also our social media presence. The goal is to create a strong virtual presence as a key element to the success and growth of the ASNR and as the singular source of information about our specialty and the society. They have initiated a formal RFA process and will shortly recommend a professional web developer and consultant firm to act as a partner with ASNR and its subspecialty societies. We shall develop a strategic plan for web staging and deployment, search optimization and development of new processes for leveraging social media for current and future members. I have also asked Meng Law and Douglas Phillips to chair the Regional and Subspecialty Societies Committee to further integrate the efforts of all of our societies for all of our collective benefits, beginning with website and eCME development.

Issue 4. Recast and promote neuroradiology as “patient-centric”

Study group: Max Wintermark (chair), Jacqueline Bello, Adam Flanders, Joshua Hirsch, Laurie Loevner, Tina Young Poussaint, Pamela Schaefer

Current status:  Recommendations include expanding the patient portal on the ASNR website with information for the patients and integrating patient centric care into the education of neuroradiology trainees and practitioners. Tina Young-Poussaint and Jacqueline Bello have been chairing a committee, including Joaquim Farinhas, Allison Grayev, David Hackney, Suresh Mukherji, Ramin Saket, Pina Sanelli, Pamela Schaefer, and Chip Truwit, to develop the patient portal, with descriptions of the main types of neuroradiology studies and procedures and with descriptions of typical neurological diseases. It is worth a look if you have not seen it. With respect to education, we are fortunate to have Laurie Loevner as President-Elect and Program Chair for the Annual Meeting of the ASNR in Chicago this April, working with Pratik Mukherjee of ASFNR, Richard Wiggins of ASHNR, Thierry Huisman of ASPNR, Adam Flanders of ASSR, Donald Frei of SNIS, and Robert Barr for the Health Policy Committees. Laurie’s theme is entitled “Getting Personal” and her entire program is dedicated to individualizing patient care, from neural networks and imaging genomics to building bridges to our patients and referring clinicians.

Issue 5. Developing Future ASNR leadership

Study group: Carolyn Meltzer (chair), Robert Barr, Jacqueline Bello, Suresh Mukherji, Gordon Sze, and Achala Vagal

Current status: Recommendations include reorganization of the ASNR governance, guided by accepted principles of non-profits to expand the Administrative Committee into a Board of Directors, to oversee operational committees, increase continuity, and provide high-level oversight of the ASNR headquarters. This proposal has been approved by the Administrative Committee and Executive Committee and has been sent to the senior membership for approval. The new Board of Directors will encompass the Administrative Committee plus several additional members, that will help in fulfilling the goals above.

Issue 6. Exploring opportunities for ASNR growth

Study group: Jim Barkovich (chair), Gil Gonzalez, Michelle Johnson, Walter Kucharczyk, Meng Law

Current status: Recommendations include international collaboration, further penetration of outreach to North American radiologists and neuroradiologists, as well as colleagues in other specialties.  One of the direct results has been the formation of the International Collaborations Committee by Mauricio Castillo, chaired by Walter Kucharczyk, with the help of R. Nick Bryan, Raquel Del Carpio-O’Donovan, Joshua Hirsch, Patricia Hudgins, Thierry Huisman, Timo Krings, Meng Law, Laurie Loevner, Cheemun Lum, Mark Mullins, Bruno Policeni, Howard Rowley, Pina Sanelli, Pamela Schaefer, Gaurang Shah, Vinil Shah, Pia Sundgren, Donatella Tampieri, Majda Thurnher, and myself, to develop ties to neuroradiologists and radiologists in developing countries. First, programs which arrange visiting professors have been arranged in conjunction with national and local radiology societies. These programs have been very successful, from both the visiting professors’ and local radiology societies’ points of view. Second, reduced rates have been developed for members from developing countries for meeting attendance and for ASNR membership. We are also investigating other avenues of development, such as satellite and virtual meetings and further collaborations with other radiology and non-radiology societies, such as NASS, which is considering a joint grant with ASNR.

OTHER ISSUES

There is one other source of stress for the ASNR which may not be quite as obvious on a day-by-day basis. From a research point of view, it is quite clear that neuroradiology itself is in a period of huge change. In the future, we shall be far more quantitative and less qualitative than we are now. Our field is getting increasingly more difficult. It is the responsibility of the ASNR to make sure that our members keep up with our evolving field. The hands-on fMRI and DTI workshops at the ASNR meeting last year were specifically instituted for this purpose. The study groups that Pamela Schaefer initiated, under the leadership of Max Wintermark, have also proved highly successful, with sessions at the ASNR and other meetings for translational fMRI and DTI, chaired by Jason Druzgal and Christopher Whitlow, vessel wall imaging, chaired by David Mikulis and Bruce Wasserman, and imaging genomics, chaired by Rivka Colen and Whitney Pope, in addition to CSF flow, chaired by William Bradley, which started three years ago.

On a national research level, we played an active role in participating in the Working Group meetings set up by Obama’s Brain Initiative, and I went to and spoke at those meetings, as well as wrote the editorial in AJNR, on behalf of not only the ASNR but also the RSNA, ACR, ISMRM, and ARR, which collectively represent over 100,000 radiologists and imaging scientists. We were concerned that human neuroimaging was being minimized in favor of basic research, both in terms of content and in terms of funding, with an emphasis from the bottom up, neuron by neuron, as opposed to the top down, with an emphasis on circuits. We are pleased to report that the NIH’s initial funding requests for proposals have been centered on human imaging.

CONCLUSIONS

The ASNR, as your organization, faces challenges. However, we are making progress and we are active at all levels. Finally, there is also good news and that is that our field has been and remains at the very cutting edge of what is exciting in medicine today.

I hope to see all of you in Chicago in April for ASNR 2015!

Gordon Sze, MD, FACR
President, ASNR

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