AI helping versus replacing radiologists- a Tale of Two pathways

There are two ways AI can enter the reading room. It can sit beside you, or it can sit in your chair. Both are already happening, and two recent examples show the difference.

Pathway one: AI as assistant

Intermountain Health reports that about 75% of its radiologists now use Smart Impression, a generative AI feature in Microsoft’s PowerScribe. Most have had it for roughly six months.

The workflow will feel familiar. You read the study and dictate your findings. The AI drafts the impression from those findings. You edit and sign. The radiologist still does the interpretation; the software handles the summary.

Intermountain cites lower cognitive load and good acceptance, but no hard numbers on productivity, turnaround time or staffing. Becker’s Hospital Review

The takeaway: radiologists will adopt AI quickly when it removes drudgery and leaves them in charge. Three out of four in half a year is fast for any new tool in medicine.

Pathway two: AI as interpreter

Radiology Partners’ Mosaic Drafting starts at the other end. Instead of working from your findings, it looks at the images and generates the draft report itself. The radiologist’s role shifts from reading the study to reviewing the machine’s read.

That sounds like a small change in sequence. It isn’t. One tool makes you faster at your job. The other is on the way to taking your job, disguised as quality control.

What’s the difference?

Both tools produce a draft. Both keep a radiologist’s signature on the report. From a distance they look alike, and adoption headlines will lump them together. But they lead to very different places:

• Assistive AI increases what each radiologist can do, increasing productivity.
• Interpretive AI reduces how much radiologist is needed per exam, so some of the interpretation fee goes to the software company, with high margins.

The Intermountain numbers show that AI in the reporting workflow is highly adopted. What is still to be determined is which pathway wins. That will be driven by radiologist decisions, legislative actions, societal pressure and cost analysis.