Dr. Geraldine McGinty

The moving image – imaging informatics’ opportunity to improve process

June 16, 2018
by Sean Ruck, Contributing Editor
With the annual SIIM conference underway, HealthCare Business News spoke with Dr. Geraldine McGinty, vice chair of the ACR board of chancellors and chair-elect, who is hosting a session focusing on the role of imaging and informatics in regard to improving patient engagement.

With increased scrutiny over healthcare costs, redundant procedures, patient safety and overall patient satisfaction, imaging informatics has a strong role to play in healthcare today. Every imaging study serves to inform physicians about course of treatment, but there is work needed to optimize the opportunities. “Understanding how to extract those data from the various information systems that we work with, it’s something that’s key to success in those programs,” said McGinty.

Part of that understanding highlights the importance of knowing where your data are and how to get data to other places as needed, said McGinty.

“I think, for various reasons, we’re not as good as we should be at transferring images between facilities, or removing patients from the burden of having to get their images from one facility to another,” McGinty explained. “Certainly, there are people who are making the attempts to do that, but too often we’re still asking patients, if they’ve had prior imaging, to bring us a CD. So that’s an opportunity for us to do better. The barriers are sometimes technology-related, sometimes operational. Health systems don’t necessarily facilitate the sharing, perhaps because they want patients to stay within their system. I think we’re also constrained by privacy regulations, though perhaps not as much as we sometimes think. McGinty believes those barriers are surmountable and with pressure to improve the patient experience, they will be cleared. We want to make sure we have those concerns addressed.

Part of the power of continuity centers on the potential for prior imaging to inform radiologists on the need or lack of need for new imaging studies, even for previous studies that weren’t necessarily for the area in question, because they may still capture needed information. “If I’m reading a chest CT and I see a tiny lung nodule, if I know that the patient had an abdominal CT a year ago, I might be able to document the stability of that lung nodule based on comparison with the previous imaging and make a different follow-up recommendation. If I don’t know there was potentially relevant prior imaging, then I’m going to go with the information I have and perhaps recommend a more extensive follow-up that I would have otherwise,” said McGinty.

One additional challenge is that we may not know in advance when we’ll need access to images from elsewhere, for example, if a patient presents to the emergency room in a location different from where they had their prior imaging. Making it easier to determine whether and where they’ve had prior imaging care would facilitate that sharing.”

To help move the needle in the right direction, McGinty says that it’s important to be connected with the informatics leadership in your hospital. “A lot of radiology groups remain independent of their hospital and provide imaging interpretation services. The group may have its own PACS for an outpatient imaging center but also need to interact with the hospital’s PACS. The group needs to build a healthy relationship with the hospital informatics team in order to facilitate their operations.

For her part, McGinty’s sessions she’s co-chairing at SIIM will offer some strategies for imaging informatics to better-engage with patients. “I think making patient reports available to them, and certainly as we look forward, making patient reports available to them in language they understand, is key. Obviously, in breast imaging we’ve been mandated for many years to give lay-summaries and the Bi-RADs lexicon has facilitated that.” Translating that to other organ systems will be important work.

“Our challenge is to make sure that we’re communicating in a personalized way to all the stakeholders who need to consume the imaging information. The radiologist, looking at the report from prior imaging, wants to see certain data, their referring colleague is looking for perhaps a different take on the same information. Most importantly in providing information to the patient, we need to be sensitive to what is meaningful and important to the patient, not just what we think they need to know.