Imaging informatics offers key to reshaping radiology’s future

With potential professional threats seeming to lurk around every corner, radiologists can expect medical imaging informatics to serve as their best defense from now until the year 2015. That was the message of Dr. Eliot Siegel's Moreton Lecture at the 2008 American College of Radiology meeting and Chapter Leadership Conference in Washington, DC.Siegel, vice chair of radiology at the University of Maryland, delved into the biggest challenges facing the next generation of radiologists. Most of these young professionals were in grammar school when PACS was introduced. They grew up with computers and learned to quickly adapt to ever-changing technologies. The next generation of radiologists may have been multitasking practically since infancy, but these skills may not be sufficient to meet the productivity demands of future practice, Siegel said. To make matters worse, their pay will surely be tied to their job performance. The age of information technology has been kind to radiologists so far. Although IT helped imagers streamline their jobs, however, it also has become widely available to consumers. Radiologists still retain control of imaging data in hospitals and imaging centers, but patients may one day become repositories of their own data. The implications are huge, according to Siegel. "There's going to be a game change in lots of different ways," Siegel told Diagnostic Imaging. "Are we going to have all of our records on Google by 2015? No, but in seven years, IT is going to have a major impact on the way that we think of patients' electronic medical records and the way we think about radiology."Medical imaging informatics is still a relatively new multidisciplinary field that intersects with biological sciences, health services, information sciences, medical physics, and engineering, Siegel said.

Despite its multiple applications in areas such as volumetric imaging and computer-aided detection, medical imaging informatics can help strengthen radiologists' control of their specialty in at least three key areas:

• radiation dose versus image quality
• productivity versus diagnostic accuracy
• communication of imaging findings

Visual Discrimination Matrix is one exciting technology in the realm of medical imaging informatics, Siegel said. VDM is a quantification tool that could define the appropriate level of radiation dose for a particular imaging application before the patient even gets close to a scanner.

Siegel and colleagues studied how to improve workflow using medical imaging informatics. They found that it took 59 steps from the point a patient was scheduled for a study until the report was sent to the referring physician. By using a model they called integration of the healthcare enterprise, they were able to reduce those steps to just nine. Communication is the most critical challenge of all, Siegel said. Despite a few changes, radiology reporting remains basically the same in many ways and is an inefficient means of communicating results. Structured reporting has been praised as one solution. With the exception of BI-RADS, however, no other feasible examples exist, and many radiologists have become skeptical about its use. Onscreen multitouch technology could become a more practical and cost-efficient way to consolidate imaging results, speech, and other interactive tools used for reporting, he said. IT has made radiologists more efficient. But the technology has come to a cost, reducing opportunities to discuss indications with clinicians and interactions with patients. In the era of personalized medicine, medical imaging informatics can be used to add value to radiology services and allow radiologists to interact more effectively with medical colleagues and patients. "We as radiologists will need to prepare ourselves by taking advantage of this emerging field," Siegel said.For more information from the Diagnostic Imaging archives:

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