A question from the radiology news media-What are the biggest challenges facing the field?-led some Society of Imaging Informatics in Medicine veterans, participants on a panel assembled by the association, into discussion of a list of issues facing radiology informatics. Their comments produced insights into hot topics to watch.
A question from the radiology news media-What are the biggest challenges facing the field?-led some Society of Imaging Informatics in Medicine veterans, participants on a panel assembled by the association, into discussion of a list of issues facing radiology informatics. Their comments produced insights into hot topics to watch.
Not all the answers were exactly new. Image overload and better integration between disparate PACS/informatics systems have been topics of interest for years. But they seem to be taking on more urgency as technology advances and the demands on imaging increase.
Other issues were more cutting edge. How radiologists report their imaging findings will need to change.
Researchers may want to mine the reports and correlate findings with biomarkers. How the reports are designed will be critical to these activities, he said.
Financial incentives are already in place to encourage radiology report reforms. Under its Physician Quality Reporting Initiative, the Centers for Medicare and Medicaid Services is offering a 1.5% bonus to practices that report specific types of data, including whether they observe guidelines for reporting carotid stenoses and certain stroke findings, Langlotz said. That program will be expanded, and what is now a bonus could become a holdback for practices that fail to meet reporting standards.
George Bowers, MBA, of Health Care Information Consultants, has worked as chief information officer at a large radiology practice and a big academic medical center. CIOs are concerned about the relationship between radiology and the electronic health record, he said. One of the big challenges for SIIM will be defining what imaging informatics is going to mean for the electronic health record.
"It's not just images popping up electronically; it's much more complex than that," he said.
One possible measurement is radiation dose, he said. Practices would probably need to capture dose information and store it. This is not easy, and, as the pay-for-performance concept progresses, practices will need informatics solutions to gather and provide those data.
"If I do a measurement-whether it's the size of tumor or vascular disease-I need to have a mechanism to know whether that's accurate," Siegel said. "I need rigorous science to make sure we move from radiology as an art form, which means producing good-looking images to be subjectively reviewed, to something we can actually use in the digital age."
Right now, software systems often provide widely varying figures for measurements of volumes or carotid stenosis, he said.
Systems integration is something computers ought to do well, but finding ways to cope in a multivendor-or even single-vendor-environment is a challenge, he said.
Sharing images concerned Siegel. The problem is resolved now by putting images on CDs, but these are often incompatible with different PACS. The issue has roused even the American Medical Association to put forward a resolution, particularly supported by neurosurgeons and oncologists, calling for a better system.
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