Informatics, standardization and the next phase for enterprise imaging

by Lauren Dubinsky, Senior Reporter | June 10, 2019
Health IT
From the June 2019 issue of HealthCare Business News magazine

Dr. Prevedello Luciano
But that’s where things were put on hold. The IDNs had to consider how much they were willing to pay various vendors to store, distribute and display these millions of non-DICOM images, all the while not getting any reimbursement for it since they aren’t ordered procedures.

“They really can't afford to leave [the images] in coat pockets because that's a HIPAA violation but they also can't afford to pay the vendors,” said Gray. “I can understand chasing after AI because there’s the possibility of reimbursements and prestige to the medical center, but at the same time we are letting a problem go unaddressed.”

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He recommended that healthcare organizations develop a plan for how to deal with their non-DICOM images and then put a date on that plan so it doesn’t get forgotten.

Standardizing workflow
Part of getting data to play nice across different “silos” means adopting a common language to communicate it. This idea is not new in imaging, but the challenge has shifted over the decades.

“Back in the late 80s and early 90s, the thing that drove us to create DICOM was the fact that each CT and MR scanner had its own format for data,” said Dr. Bradley Erickson, associate chair in the department of radiology at Mayo Clinic. “I think the same is true now for workflow.”

Erickson is involved in developing a standard that can interoperate workflow events between PACS, RIS, scanners and the EMR, allowing clinicians to see the workflow status of the images.

The standard is called the SIIM Workflow Initiative in Medicine (SWIM) and it’s now a part of RadLex — Radiological Society of North America’s controlled body of terminology, or lexicon, for use in radiology reporting, decision support, data mining, etc.

Unfortunately, adoption of SWIM has been slow.

“If we don't have some way to orchestrate that in a standard way, we're not going to get there, and instead we’ll have companies that want to lock you into their ecosystem,” said Erickson. “Soon you will either have to support many platforms or you will have to be satisfied with the tools on one platform.”

He speculated that as AI gets more and more pervasive, it’s going to drive the need for better workflow orchestration across different systems. That will then drive the adoption of vendor-neutral terminologies for workflow.

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