Dr. Paul Nagy

SIIM – Q&A with Dr. Paul Nagy, 2016 SIIM Chair

June 16, 2016
by Sean Ruck, Contributing Editor
In advance of SIIM’s annual meeting, being held in Portland, Oregon, from June 29 to July 1, HealthCare Business News interviewed incoming society chair Paul Nagy to learn about his background and where he hopes to lead the society.

HCB News: How did you get involved in health care?
I love experimental physics and computer science and I did a Ph.D. program at the Medical College of Wisconsin. I took classes with medical students and had great mentors on partnering with physicians and nurses to engineer new solutions to clinical problems. I spent many weekends in the CT control room imaging anthropomorphic phantoms. This is the early 1990s, so I became the PACS, literally. I was the sneakernet of ACR NEMA format for medical images on optical disks transferring them back and forth from DAT tapes. I worked on computer vision segmentation projects using some of the early imaging libraries. The interactions I had with radiologists and technologists taught me the most on how to be a technical liaison and colleague.

I went to work for GE medical in the mid-1990s working with X-ray tube engineering. During that time, I fell in love with Six Sigma and its progressive management principles. I was brought back to the Medical College of Wisconsin as a faculty member in 2001 to lead them through their big transition from film into the digital environment.

HCB News: What had them reaching out to you for the opportunity?
The chairman remembered I was the guy that helped everyone with their computers. I guess the perk of being PC support was that I had access to every aspect of radiology and even got noticed by its leadership.

HCB News: How did you get involved in SIIM?
It really started with me at SCAR in 2001, in Utah. SIIM was known as SCAR, the Society for Computer Applications in Radiology, at the time and PACS was beginning to shift to the more modern systems from engineering exercises. There I met Eliot Siegel, who became a great mentor, and quickly realized that SIIM is about community, networking and learning best practices from others. There are so many changes that go on when you deploy a health IT system. Having those connections were invaluable. I got involved with committees and shared what I learned with others. I grew professionally with SIIM and in many ways am a product of SIIM. Helping others through the society is where I learned a lot about leadership. SIIM is an amazing multi-disciplinary society where radiologists, computer scientists, imaging informatics professionals, administrators, technologists and industry work side by side to improve health care.

HCB News: What’s the major initiative or initiatives, you plan to push during your time as chair?
I am a teacher at heart and I plan to continue to strengthen SIIM’s tradition to create future leaders in imaging informatics. SIIM provides great educational content in our field through presentations at our annual meeting and online through our webinars. SIIM convenes researchers and industry in the field through our annual meeting and peer reviewed JDI journal to discuss the latest discoveries and technologies. SIIM brings together professionals in the field to network and exchange best practices.

I believe the greatest contribution to the field that SIIM makes is in creating the leaders for the next generation. You can become an expert by helping others. Answering a question, giving a presentation, serving on a committee, creating a new guideline, publishing a paper as well as creating applications and participating in our hackathon. These are all ways our members can become national leaders in the field. I’d like to build programs to recognize those that are helping others and contributing to the field. The industry needs more leaders that can take technology and partner with physicians and tailor it to the clinical environment.

I am very interested in continuing David Brown’s efforts to get more members engaged in SIIM. Members can now be engaged with SIIM at the annual, participate in our monthly webinars and interact through our growing online virtual community. There are a few other things I want to do — one of the challenges we need to address is to be able to better-manage images, to be able to see the longitudinal methods, because we’ll be seeing a time when patients are engaging in their medical care more than ever before, and SIIM is providing the tools.

Also exciting is interoperability and the evolution of our medical standards we use to move information within a health care system and beyond. Those standards have been around for 20 years and within the last few years, they’ve been going through a sea change toward Internet standard web services.

HCB News: Are there any big developments for SIIM that you’d like to highlight?
We’ve had a great partnership with HIMSS as a way to incorporate imaging into the enterprise. We’ve created a series of white papers and it’s been a highly productive group.

HCB News: What tops the membership’s wish list for what they want from the society?
Certainly they want to stay up with new technology, so we do a lot of education at the meeting by national leaders. Our monthly webinar series has been very successful. There’s a lot more education outside the annual meeting now. We’re having a regional meeting as well that includes education opportunities, networking and peer networking.

One pattern we’ve detected is that people going for certification in imaging informatics have to learn technical and clinical skills to be successful. So technologists come in with clinical skills, or an IT person with very technical skills. If we pair them up in boot camps, it helps them become fully aware of all sides of the field.

HCB News: How has the role of informatics in health care changed over the last decade? And how has the professional practice of informatics changed as well?
The world of biomedical informatics is colliding. The silos are connecting from imaging informatics working with images, medical informatics — diagnostic prediction analysis, public health — population health information, bio informaticists with gene expressions. We’re trying to combine these areas of expertise to find the greatest value for the patient. All these different fields need to integrate with standards to connect them. It’s very exciting. We’ve had these different groups with different data models and standards and we’re all trying to get into the same place now to get patients the best possible care and detect and prevent health care problems.

HCB News: What are the biggest challenges facing informatics professionals today?
On the clinical side, this year’s theme is leading change. It’s not just about technological leadership, but your ability to influence others and understand complex environments as teams work together. As technology professionals we have to understand that we are bridging two different cultures and it requires us to often act as a liaison to help groups deliver better care for patients with technology. On the research side, we have a lot of promising and powerful tools from machine and deep learning. At the same time we are seeing increasing risks and need to ensure we keep patient information secure.

HCB News: Have there been any breakthroughs or legislative pushes you’re particularly optimistic about?
I think what’s exciting is the fact that the overall EMR adoption rate has gone through the roof, enabling us to have enterprise data we never had before. Ordering physicians are applying appropriateness criteria with decision support in a very granular way, allowing us to better understand the reason for the exam and be able to follow up on the patient to see how the report impacted patient care.

HCB News: What do you think the field will look like 10 years from now?
I see the next generation of PACS systems based upon telehealth platforms where radiologists can collaborate with referring physicians. I would say that over the next 10 years we have a big job transforming the field of medicine. We need to make it work much better for patients and providers alike. We need to ensure that data isn’t buried and that radiologists can navigate and synthesize the complete medical record. The amount of data we’re generating is accelerating, so we have our work cut out for us.

I can’t foresee the pace of technological change slowing anytime soon. There will always be the ongoing need for people who will be able to understand technology at a deep level to be able to work with radiologists and other clinical providers in bringing the technology into the clinical environment, and improving the health of our patients.