Heading up the Johns Hopkins Medicine Technology Innovation Center, Gorkem Sevinc, MSE, CIIP, focuses the bulk of his attention on partnering with clinical and research personnel within Hopkins Medicine to collaboratively build innovative Health IT tools. Software development, IT infrastructure, workflow and collaboration tools are all part of his purview.
Sevinc started the informatics research laboratory in the Department of Radiology at Johns Hopkins Medicine along with his director and chair-elect of SIIM, Paul Nagy, PhD. They grew it to serve all of Johns Hopkins Medicine’s Health IT needs, but the department of radiology continues to be the lab’s anchor.
HealthImaging/Viztek sought him out after hearing him speak at the 2015 annual meeting of the Society for Imaging Informatics in Medicine (SIIM). There, he stumped his session’s attendees by asking what they thought was the most important thing to remember about analytics. Data, outcomes, and visualization, they guessed. Wrong, wrong and wrong, responded Sevinc, who is also CTO of two startups, a medical imaging second-opinion service he co-founded and a mobile health company that supplies a platform for remote patient management. “The most critical part of analytics,” he said, is “the story.”
Sevinc spoke by phone from Baltimore, where the imaging departments of Hopkins’s two main hospitals and two imaging sites generate in the neighborhood of 700,000 diagnostic images per year. Here are excerpts from the conversation.
Q: If you had the chance to design the optimal PACS from scratch, what would it look like?
Sevinc: Enterprise image viewers, which is a web-based technology, with server-side rendering and zero footprint viewers—that is the future. I agree with my friend Don Dennison who predicts PACS will be dead by 2018, replaced by web-based image viewers providing PACS-level functionality.
If I were designing the optimum PACS, I would challenge why the RIS and PACS are still separate and different systems. With the advancements of DICOMweb and HL-7 FHIR, we’re going to have a lot of flexibility compared with the standards we used in the past. We’ll innovate a lot faster.
Another friend and SIIM Hackathon Committee Member, Chris Hafey, designed an open source viewer called Cornerstone, which utilizes DICOMweb. It’s amazing that anyone can image-enable their application by grabbing Cornerstone online—this is a prime example of open source and web-based technologies increasing the pace of innovation. Our goal should be to continue building and utilizing modern building blocks, which also help us concentrate on solving clinical problems.
Q: What are the real problems?
Sevinc: In the HL-7 world, we are still struggling with doing integration. In the DICOM world, more or less the same thing. Hopkins is going through Epic rollout for inpatient clinics. We have been spending ridiculous amounts of time just doing HL-7 integration testing. In my dead honest opinion that is a complete waste of time. I do not want engineers spending time integrating one system with another. That is not exciting, that is not interesting, that is not what we should be working on in 2015. Hopefully, web-based technology is going to reduce the amount of time we spend integrating and increase the amount of time we spend innovating.
Q: How can new and emerging IT technologies and platforms make a difference?
Sevinc: The DICOM and HL-7 technologies alone are going to make a huge difference.
Some of the EMR vendors are starting to make their data more public. One of the biggest challenges in a hospital system is getting access to data. Yes, we have to protect access to the data, and we have to be very careful about who gets what access to which data, especially with HIPAA’s need-to-know requirements. At the same time, we need to think about how we can keep up with the evolving needs of care delivery.
We have patients who need more access to data. We have patients who want to see their imaging. In this day and age, we still send people outside the hospitals with CDs of their images in their hand. I’m sorry, but that’s crazy! I don’t even have a computer at my house that I can put a CD in.
Image-sharing vendors are making a good dent in this problem, and the RSNA Image Share Network is driving quite a bit of the change along with health systems. I believe we have to step back and think about the end goal: We need to give patients access to their data. That has to be the top priority. A patient