Assessing the next generation of imaging IT

February 14, 2022
Health IT
From the January/February 2022 issue of HealthCare Business News magazine

By Don Dennison

Over the past couple of years, IT groups have been challenged to provide new value for organizations forced to adapt their enterprise to operate with staff working remotely and with sudden and wide variations in business workload. Imaging IT is no different. While imaging modalities have remained on-premises at healthcare provider facilities to acquire imaging exam data, many of the functions, such as diagnostic reading, have moved to work remotely.

Working as an imaging IT consultant, and volunteer with many imaging informatics organizations, I am often exposed to the evolving needs of healthcare provider organizations, as well as how industry is adapting their solutions to meet these needs.
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I attended the RSNA in Chicago in person in 2021, meeting with several vendors, along with healthcare providers seeking new imaging IT solutions, like a PACS, VNA, or other.

This article provides a summary of trends I have observed not only at the RSNA, but from discussions throughout the past year or so.

State of RIS
In early 2020, I wrote an article on the two prevailing types of RIS: stand-alone and as part of the EMR. A year later, and the observations still ring true. Healthcare systems are overwhelmingly opting for a RIS provided as part of their EMR (for which the healthcare system already has a contract in place), sharing many of the same database tables (with fewer interfaces to build) and application servers. They use the embedded RIS to place imaging exam orders, schedule appointments, and support the department’s operations. Depending on the solution, it may also provide the DICOM Modality Worklist and the Radiologist’s reading worklist. While standalone RIS may provide more functions, the appeal of maintaining a single system often wins out.

Standalone RIS continue to evolve and provide many modern features to operate in today’s environment, such as automated appointment reminders and exam prep instructions by text message, or apps (or text message-based options) to allow patients to wait in their car until it is time to come in for their appointment. Analytics in these solutions are often robust, as the buyer — such as a chain of imaging centers — is often counting on this data to optimize their productivity and revenue stream.

State of reporting
For years, I have heard thought leaders extol the benefits of structured, multimedia reporting for radiology. While more common in cardiology and the breast imaging subspecialty, this has not gained wide adoption in the broad Radiology community. Some of the challenge is radiologist habits (many were trained to produce narrative reports), but there have been real and significant technical challenges, especially in a mixed-vendor solution environment. Developing highly structured reports has been possible for some time (although getting Rads to all agree on and adopt this structure is not always easy), but getting the structured values from the modality and PACS (created during the diagnostic review) into the right report fields was limited, due to a lack of APIs to pass this data in real time. The same can be said of embedding images, tables of values, or other multimedia content into the report. Single-vendor solutions that provide methods to receive and process structured data from the modality, and provide structured reporting and image display are available on the market, but most organizations have adopted separate applications for image display (PACS) and reporting.

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