In May of 2020, the first wave of the COVID-19 pandemic was crashing on the U.S. and Howard B. Fleishon, MD, MMM, FACR, was just beginning his term as chair of the ACR BOC. Although the pandemic was only a few months old at the time, it had already become clear that to succeed during the sustained crisis, organizations across the world would have to adapt — and the ACR was no different. From the beginning, Fleishon set a tone of resilience and flexibility that is carrying into his second year as chair of the BOC.

As part of this shared effort, in October of 2020, Fleishon asked ACR staff and commission chairs to “reimagine” the ACR and boldly commit to bringing the College forward in new and innovative ways. During a recent interview in the Bulletin podcast, Fleishon explained his rationale for refocusing the College’s approach to some of its most fundamental activities to best serve its members.

How have you adapted to your term being interrupted by the pandemic?

I think anyone coming into a BOC position has several items and initiatives that they’d like the Board, Council, and membership to consider to keep moving the College forward. In this situation, external factors impacted that process. In a lot of ways, COVID-19 changed everything — but because of the hard work of our staff, the College maintained its financial stability. ACR became a reliable resource for our members and patients as they realized the harsh realities of the pandemic.

Why was it important to “reimagine” aspects of the ACR?

It’s very unlikely that we’ll return to the status quo in the post-pandemic era. As a society, we’ve had to adapt and rethink everything we’re doing. For radiology specifically, our practices experienced low volumes at the peak of the crisis. But even after we rebounded, we had to rethink our processes about how to keep our patients and ourselves safe. The ACR has focused on supporting our members and their practices and patients through the challenges of each stage of the pandemic. We’re committed to continuing to lead radiology as we shape the future of our specialty and imaging in healthcare.

Internally, many of the ACR staff had to begin working from home during the pandemic’s onset in March of 2020. Remarkably, more than a year later, staff satisfaction and productivity remain high — and a good proportion of the staff has expressed a desire to have the work-from-home option open to them post-pandemic. This allows us to evaluate office space allocation and opens up avenues for us to recruit nationally, rather than limiting ourselves to the Washington, D.C. workforce.

Externally, the ACR created new content for members and new ways to deliver that content. For instance, ACR 2020 and ACR 2021 took place virtually. We were very concerned in 2020 about annual meeting attendance, but discovered that attendance was at a record high. Going forward, as we transition back to in-person meetings, we may incorporate a hybrid version of the meeting so that those who can’t make it to Washington, D.C. will still be able to participate remotely.

What are some enduring changes you foresee?

COVID-19 was the catalyst for starting this conversation on reimagining the College, but it’s now an ongoing effort about breaking down silos and continuous improvement as we represent our members, patients, and the specialty.

For instance, data science is a new frontier. The ACR Data Science Institute® (DSI) and the Commission on Informatics are reimagining themselves on a weekly basis because of the rapid pace of change in AI. Our Data Science Summit took place virtually last year and we’ll probably have a hybrid model going forward.

The College has made major strides in converting its educational offerings to online and hybrid models during the pandemic. Do you foresee this hybridized learning model continuing post-pandemic?

At the height of the pandemic, the Commission on Publications and Lifelong Learning and other ACR commissions created unique educational content, as well as new mechanisms to deliver that content. For example, the ACR Education Center, which is very popular among members and non-members, had to be shut down due to social distancing guidelines. So, we moved the Education Center’s case engine online to facilitate remote learning activities and came up with synchronous and asynchronous online micro-courses that we could offer attendees.

COVID-19 was the catalyst for starting this conversation on reimagining the College, but it’s now an ongoing effort about breaking down silos and continuous improvement as we represent our members, patients, and the specialty.

How has the College refocused its quality and safety efforts over the past year?

During the pandemic, both the leadership and staff of the Commission on Quality and Safety were vital in presenting guidelines and recommendations to our membership. Accreditation submissions are almost exclusively done electronically now. We are also reimagining the customer experience. Additionally, ACR’s new image-sharing platform, ACR Connect, will be foundational for many aspects of the College going forward, including quality and safety.

How much has the pandemic influenced the update of the ACR Strategic Plan?

The strategic planning initiative started before COVID-19 and is part of a routine cycle where we refresh the plan every few years. Back in 2014, when we initiated the process for our current strategic plan, we actually brought up the possibility of a pandemic during the environmental surveillance exercise. It didn’t make it to the top tier of considerations since it was considered so unlikely. Going forward, we’re making environmental surveillance an ongoing process embedded in a committee within the Commission on Leadership and Practice Development.

How will you encourage more active collaboration between ACR commissions and departments going forward, and what do you hope that will accomplish?

The initial impetus to start the reimagining conversation was to break down silos between ACR commissions and departments, eliminate redundancy and waste, and reduce costs during the pandemic. We’ll continue working across silos so we leverage every resource of the College to deliver world-class programs to our members.