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Q&A with David Brown, chair of SIIM

by Sean Ruck, Contributing Editor | April 13, 2015
From the April 2015 issue of HealthCare Business News magazine

HCBN: What do you believe are the biggest challenges facing the imaging informatics sector in the coming years?
Interoperability is a big one. There is an urgent need to provide an infrastructure that supports the exchange or sharing of images between providers across a region and across the nation. Without an adequate infrastructure, the sharing of images between providers will be a series of one-off solutions that will only continue to challenge health imaging IT going forward.

Consider secure image exchange as one example. The number of vendors who are providing secure image exchange solutions is increasing, particularly now that PACS vendors are offering this functionality. What I am seeing in today’s cloud-based image sharing market reminds me of CD-based image exchange. A hospital or provider will select their preferred solution for image exchange, and then want to share or exchange images using this solution with others. This is not a problem if the hospital is partnered with other providers who use the same vendor solution, but quickly becomes one if the other provider has elected another solution.

Now, the providers are faced with which vendor solution to use, particularly if there is the desire to share images in both directions. Now expand this scenario to include multiple healthcare providers wanting to exchange images with each other, and each of these providers has selected a different image exchange or PACS vendor for sharing images. The picture becomes ugly quickly. The picture becomes even uglier when one considers the fact that each image exchange solution has its own software with its own special workflow and user interface. Is it reasonable to expect a facility to train its personnel to support different workflows and user interfaces on a provider-by-provider basis?

This is why I stated that the current cloud-based market reminds me of CD exchange. Each vendor solution is different from the other, and a provider who receives CDs is tasked with figuring out what to do with the different ways in which the imaging data is presented. What is needed is a standard approach to sharing images across providers and across vendors. There are standards such as XDS-I, but there is not sufficient infrastructure supporting this standard across our nation. HIEs have adopted XDS for the exchange of results, but have been slow to adopt XDS-I for the exchange of images. There are also emerging standards such as DICOMWebRESTful services that can be leveraged with increased adoption of these new standards.

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